NPIMap

Individual provider Active NPI

Nathan Michael Larsen, M.D.

  • Emergency Medicine Physician
  • Waupaca, WI
National Provider Identifier
1992887848
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
48825-020 Issued in WI
Practice address
800 Riverside Dr
Waupaca, WI 54981-1943
Phone
(715) 258-1000
Fax
(715) 258-2000
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 48825-020 WI Primary

Addresses

Primary practice location

800 Riverside Dr
Waupaca, WI 54981-1943

Mailing address

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1000

Other practice location 1

225 Memorial Dr
Berlin, WI 54923-1243
Phone (920) 361-1313

Other practice location 2

100 County Road B
Shawano, WI 54166-7072
Phone (715) 526-2111

Other practice location 3

1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2000

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address nlarsen331936@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other
Direct Messaging Address nathan.larsen@thedacare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070618000165 WI Practitioner - Emergency Medicine 4082713060 Reassigns benefits to 19 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare Regional Medical Center - Appleton, Inc 14 clinicians

Practice addresses (Care Compare)

755 W Johnson St
Fond Du Lac, WI 54935-2089
Phone (920) 913-4400

Hospital & facility affiliations

  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
  • Thedacare Medical Center - Berlin Inc Hospital, Berlin, WI, CCN 521355
  • Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48825-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Regional Medical Center - Appleton, Inc. CurrentSince Apr 16, 2025 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Jul 9, 2007 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Jun 15, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 25, 2022 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jun 15, 2022 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Current Accepting new patients
MCHS Hospitals Inc CurrentSince May 25, 2022 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jul 9, 2007 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jun 15, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince May 25, 2022 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jun 15, 2022 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Wild Rose, Inc CurrentSince Mar 30, 2024 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Emergency Medicine CurrentSince Jun 15, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince May 25, 2022 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jun 15, 2022 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jun 15, 2022 Accepting new patients
MCHS Hospitals Inc Emergency Medicine Current Accepting new patients
Flambeau Hospital Inc CurrentSince May 25, 2022 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jun 15, 2022 Accepting new patients
Memorial Hospital Inc CurrentSince May 25, 2022 Accepting new patients
Flambeau Hospital Inc CurrentSince May 25, 2022 Accepting new patients
Thedacare Regional Medical Center - Appleton Inc. CurrentSince Apr 16, 2025 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

755 W Johnson St
Fond du Lac, WI 54935
Phone (920) 731-4101

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

4100 State Highway 66
Stevens Point, WI 54482
Phone (715) 343-7700

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

601 Grove Ave
Wild Rose, WI 54984
Phone (888) 287-4488

Interoperability endpoints

  • Direct secure messaging: nathan.larsen@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: nlarsen324098@direct.thedacare.org
  • Direct secure messaging: nlarsen331936@direct-ehr-ssmhc.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 29

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.

View all 29

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1992887848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "715-258-1000",
            "fax_number": "715-258-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "715-258-1000",
            "fax_number": "715-258-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231243",
            "country_code": "US",
            "telephone_number": "920-361-1313",
            "fax_number": "920-361-5499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 County Road B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541667072",
            "country_code": "US",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-9166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 Mill St",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "WI",
            "postal_code": "549612155",
            "country_code": "US",
            "telephone_number": "920-531-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-11-17",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "48825-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nlarsen331936@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "nlarsen331936@direct-ehr-ssmhc.com",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nathan.larsen@thedacare.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "800 Riverside Dr",
            "city": "Waupaca",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549811943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.