NPIMap

Individual provider Active NPI

Larry Croft Munch, MD

  • Urology Physician
  • Boulder, CO
National Provider Identifier
1205836889
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01055149A Issued in IN
Practice address
2750 Broadway St
Boulder, CO 80304-3573
Phone
(303) 440-3093
Fax
(303) 440-3161
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01055149A IN Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3573

Mailing address

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3093

Other identifiers 1

IdentifierTypeStateIssuer
200333830AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190131001363 WI Practitioner - Urology 4082757869 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Kentucky College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical Center IncGroup PAC ID 8022000447, 80 clinicians
Aspirus Ironwood Hospital and Clinics IncGroup PAC ID 9032013198, shared by 5 NPIs, 165 clinicians

Practice addresses (Care Compare)

1615 Maple LN
Ashland, WI 54806-3626
Phone (715) 682-5500

N10561 Grandview LN
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10561 Granview LN
Grand View Hospital
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10565 Grand View Lane
Ironwood, MI 49938-9622

N10565 Grandview Lane
Ironwood, MI 49938-9622

N10565 Grandview LN Aspirus Ironwood
Ironwood, MI 49938-9622
Phone (715) 843-1067

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.19 of 100Reported as group
Quality
74.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01055149AINMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 21, 2019 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 9, 2020 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 21, 2019 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jan 21, 2019 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Jan 21, 2019 Accepting new patients
Memorial Medical Center Inc CurrentSince Oct 1, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 9, 2020 Accepting new patients
Memorial Medical Center Inc CurrentSince Oct 1, 2022 Accepting new patients
Medical Services, Inc Past Accepting new patients
Major Hospital Past Accepting new patients
Indiana Clinic - Urology, LLC Urology Past Accepting new patients

Locations

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: larry.munch@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1205836889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3093",
            "fax_number": "303-440-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3093",
            "fax_number": "303-440-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCH",
        "first_name": "LARRY",
        "middle_name": "CROFT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01055149A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200333830A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2750 Broadway St",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803043573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.