Active NPI
Jennine Larson, M.D.
- Surgery Physician
- Wausau, WI
National Provider Identifier
1942412044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 51726
- Practice address
- 2400 Pine Ridge Blvd
Wausau, WI 54401-7803 - Phone
- (715) 847-2022
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Trauma Surgery Physician | 2086S0127X | 51726 | WI | |
| Surgery Physician | 208600000X | 51726 | WI | Primary |
Addresses
Primary practice location
2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Mailing address
2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35352800 | Medicaid | WI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.56 of 100
- Quality
- 90.89
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 20 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 15 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51726 | WI | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Associates, S.C. | Surgery | Current | Accepting new patients |
Locations
2606 Stewart Ave
Ste 200
Wausau, WI 54401
Phone (715) 847-2022
2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022
Interoperability endpoints
- jlarson19596@direct.aspirus.org
Organizations & group practices 1
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.
-
- Surgery Physician
- Wausau, WI
- NPI 1710910476
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1942412044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 PINE RIDGE BLVD",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544017803",
"telephone_number": "715-847-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 PINE RIDGE BLVD",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544017803",
"telephone_number": "715-847-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "JENNINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "WI",
"license": "51726",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "51726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35352800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.