Individual provider Active NPI

Angelica M. Larson, NP

  • Nurse Practitioner
  • Eau Claire, WI
National Provider Identifier
1609217298
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5338 Issued in WI
Practice address
733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone
(715) 838-5222
Fax
(715) 838-5021
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5338 WI Primary

Addresses

Primary practice location

733 W Clairemont Ave
Eau Claire, WI 54701-6101

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (715) 838-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alarson23692@ehrdirect.mayoclinicmsg.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000383 WI Practitioner - Nurse Practitioner 5395988422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5338WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

2409 Stout Rd
Menomonie, WI 54751
Phone (715) 231-3937

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

Interoperability endpoints

  • Direct secure messaging: alarson23692@ehrdirect.mayoclinicmsg.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1609217298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016101",
            "telephone_number": "715-838-5222",
            "fax_number": "715-838-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANGELICA",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alarson23692@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "733 W Clairemont Ave",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.