Individual provider Active NPI

Skylar M Larsen, MD

  • Emergency Medicine Physician
  • Madison, WI
National Provider Identifier
1437738481
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
81897-20 Issued in WI
Practice address
750 Highland Ave
Madison, WI 53705-2221
Phone
(608) 263-4900
NPI assigned
Apr 6, 2021
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 81897-20 WI Primary

Addresses

Primary practice location

750 Highland Ave
Madison, WI 53705-2221

Mailing address

921 S Brooks St Apt 6
Madison, WI 53715-1977
Phone (801) 362-3963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240502002304 WI Practitioner - Emergency Medicine 7416358411 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians
Stoughton Hospital AssociationGroup PAC ID 7012825706, 66 clinicians

Practice addresses (Care Compare)

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5566

900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81897-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swea Fort SC Emergency Medicine CurrentSince Oct 18, 2024 Accepting new patients
Southern Wisconsin Emergency Associates SC Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Stoughton Hospital Association CurrentSince Jan 1, 2026 Accepting new patients
Stoughton Hospital Association CurrentSince Jun 1, 2024 Accepting new patients
Stoughton Hospital Association CurrentSince Jun 1, 2024 Accepting new patients

Locations

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

5614 US Highway 51
McFarland, WI 53558
Phone (608) 838-8242

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Interoperability endpoints

  • Direct secure messaging: slarsen511209@direct-ehr-ssmhc.com

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1437738481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S BROOKS ST APT 6",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151977",
            "telephone_number": "801-362-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052221",
            "telephone_number": "608-263-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "SKYLAR",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81897-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.