Individual provider Active NPI

Mark Daniel Larson, MD

  • Glaucoma Specialist (Ophthalmology) Physician
  • Greenfield, WI
National Provider Identifier
1831651868
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
84144-20 Issued in WI
Practice address
4600 W Loomis Rd Ste 310
Greenfield, WI 53220-4858
Phone
(414) 281-0424
Fax
(414) 281-0959
NPI assigned
Mar 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 84144-20 WI Primary
Ophthalmology Physician 207W00000X 73841 MN

Addresses

Primary practice location

4600 W Loomis Rd Ste 310
Greenfield, WI 53220-4858

Mailing address

4600 W Loomis Rd Ste 310
Greenfield, WI 53220-4858
Phone (414) 281-0424

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
I20240822003876 WI Practitioner - Ophthalmology 4082037999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Sanford School of Medicine of University of South Dakota, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmology Associates S CGroup PAC ID 6204723869, 9 clinicians

Practice addresses (Care Compare)

4600 W Loomis Rd
Suite 310
Greenfield, WI 53220-4858
Phone (414) 281-0424

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

Merit-based Incentive Payment System (MIPS)

Final score
80.11 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
60.18

Merit-based Incentive Payment System (MIPS)

Final score
92.27 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84188WIMDFamily Medicine Physician
84144-20WIMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Associates S C Ophthalmology CurrentSince Aug 1, 2024 Accepting new patients
Ophthalmology Associates S C Ophthalmology CurrentSince Aug 1, 2024 Accepting new patients

Locations

6020 S Packard Ave
Cudahy, WI 53110
Phone (414) 294-4660

4600 W Loomis Rd
Ste 310
Greenfield, WI 53220
Phone (414) 281-0424

2500 W Layton Ave
Ste 110
Milwaukee, WI 53221
Phone (414) 281-0424

14555 W National Ave
Ste 130
New Berlin, WI 53151
Phone (262) 784-3937

14300 W National Ave
Ste 200
New Berlin, WI 53151
Phone (262) 784-3937

Interoperability endpoints

  • Direct secure messaging: mlarson@oasc.intellechartdirect.net

Organizations & group practices 2

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": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1831651868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 W LOOMIS RD STE 310",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204858",
            "telephone_number": "414-281-0424",
            "fax_number": "414-281-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 W LOOMIS RD STE 310",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204858",
            "telephone_number": "414-281-0424",
            "fax_number": "414-281-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "WI",
            "license": "84144-20",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "73841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.