Ambulatory Surgical Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Oshkosh, WI
NPI 1891717823 · NPPES record last updated Feb 9, 2026
Key facts
- NPI
- 1891717823
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- AMBULATORY SURGICAL CENTER, LLC
- Practice address
- 2120 S Washburn St
Oshkosh, WI 54904 - Phone
- (920) 236-3550
- Fax
- (920) 238-3169
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Eric Larson, M.D.
- Title
- Medical Director
- Phone
- (920) 236-3550
Member of 1
Practitioners 2
-
Eric M Larson, M.D.
-
Meisha Raven, D.O.
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Ambulatory Surgical Center LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0979867 | Ambulatory Surgical Center, LLC | Certificate of waiver | Nov 1, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091217000358 | WI | Part B Supplier - Ambulatory Surgical Center | 1759421050 | Practice locations: Oshkosh, WI |
National Provider Directory
Locations
2120 S Washburn St
Oshkosh, WI 54904
Phone (920) 236-3550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
2120 S Washburn St
Oshkosh, WI 54904
Mailing address
2120 S Washburn St
Oshkosh, WI 54904
Phone (920) 236-3550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NPI 1619957230 | Other | STEPHEN J MERFELD | |
| 41911700 | Medicaid | WI | |
| NPI 1437244621 | Other | BRADLEY N LEMKE | |
| NPI 1275513467 | Other | ERIC M LARSON |
Other providers in Oshkosh, WI
- Thomas S Altepeter
- Peter Altschwager
- Ammar Alzoubi
- Abby Amacher
- Brittany L Aman
- American Current Care P.a.
- Diane P Ames
- Richard E Ames
- Ryan P Ames
- Shakellah Amini
All providers in Oshkosh, WI · Ambulatory Surgical Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.