Individual provider Active NPI

Bryan Larson, MD

  • Orthopaedic Surgery Physician
  • Rapid City, SD
National Provider Identifier
1316048937
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
42688-20 Issued in WI
Practice address
7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone
(715) 236-8100
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 42688-20 WI Primary
Orthopaedic Surgery Physician 207X00000X 11638 SD

Addresses

Primary practice location

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050414000201 WI Practitioner - Orthopedic Surgery 7012954712 Reassigns benefits to 2 organizations
I20190827003439 SD Practitioner - Orthopedic Surgery 7012954712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Sanford School of Medicine of University of South Dakota, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians

Practice addresses (Care Compare)

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11638SDMDOrthopaedic Surgery Physician
42688-20WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince May 14, 2021 Accepting new patients
Bellin Memorial Hospital Inc Orthopaedic Surgery CurrentSince May 14, 2021 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 14, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince May 14, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

744 S Webster Ave
Fl 7
Green Bay, WI 54301

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: blarson307721@direct.thedacare.org
  • Direct secure messaging: blarson924860@direct.emplifyhealth.org
  • Direct secure messaging: bryan.larson@bhosc.directbygreenway.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1316048937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028754",
            "telephone_number": "715-236-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BRYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "42688-20",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": "11638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.