Susan Larson, in Kenosha, WI - Medicare Dietitian, Registered Provider

Susan Larson, is a medicare enrolled "Dietitian, Registered" provider in Kenosha, Wisconsin. Her current practice location is 1020 35th Street, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 767-6487.

Susan Larson is licensed to practice in Illinois (license number 812643) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588370902.

Contact Information

	Susan Larson,
	1020 35th Street, Kenosha, WI 53140
	(262) 767-6487
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Susan Larson
Gender	Female
Speciality	Dietitian, Registered
Location	1020 35th Street, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588370902
Provider Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023

Medicare PECOS Information:

PECOS PAC ID: 3476919713
Enrollment ID: I20230511002814

Medical Identifiers

Medical identifiers for Susan Larson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588370902	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	3633-29 (Wisconsin)	Secondary
133V00000X	Dietitian, Registered	812643 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susan Larson allows following entities to bill medicare on her behalf.

Provider Name	Aurora Medical Group, Inc.
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan Larson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Susan Larson, 1020 35th Street, Kenosha, WI 53140-1902 Ph: (262) 767-6487	Susan Larson, 1020 35th Street, Kenosha, WI 53140 Ph: (262) 767-6487

Reviews and Comments

Dietitian, Registered in Kenosha, WI

Mr. Dean Spangle, MS, RD, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1617 73rd St, Kenosha, WI 53143 Phone: 262-653-1771
Abigail Jean Olcott, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 13032 71st St Apt 7118, Kenosha, WI 53142 Phone: 309-397-6406
Kara Winslow, M.S., R.D., C.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-7083 Fax: 262-948-7086
Emily Jane Collins, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4536 22nd Ave, Kenosha, WI 53140 Phone: 262-646-0044
Lindsay Swartz, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10400 75th St Ste 316, Kenosha, WI 53142 Phone: 262-948-6692
Jaclyn Jozefiak, RDN, MS Dietitian Medicare: Not Enrolled in Medicare Practice Location: 6838 93rd Ct, Kenosha, WI 53142 Phone: 262-909-9282
Megan Labine, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-7084

Susan Larson, - Medicare Dietitian in Kenosha, WI