| Matthew Erick Larson, | |
|
600 Highland Ave, Madison, WI 53792-0001 | |
| (608) 263-6400 | |
| Not Available |
| Full Name | Matthew Erick Larson |
|---|---|
| Gender | Male |
| Speciality | Nuclear Medicine |
| Experience | 8 Years |
| Location | 600 Highland Ave, Madison, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316444615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 73825-20 (Wisconsin) | Secondary |
| 207UN0902X | Nuclear Medicine - Nuclear Imaging & Therapy | 73825-20 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Wi Hospitals & Clinics Authority | Madison, WI | Hospital |
| Unitypoint Health - Meriter | Madison, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Wisconsin System Non Payroll | 9133024888 | 111 |
| Group Health Cooperative Of South Central Wisconsin | 3870489586 | 233 |
| University Of Wisconsin Medical Foundation Inc | 6608785464 | 2537 |
| Entity Name | University of Wisconsin Medical Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
| Entity Name | University of Wisconsin System Non Payroll |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346266319 PECOS PAC ID: 9133024888 Enrollment ID: O20031204001102 |
| Entity Name | Group Health Cooperative of South Central Wisconsin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245260165 PECOS PAC ID: 3870489586 Enrollment ID: O20040227000306 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Erick Larson, 7974 Uw Health Ct, Middleton, WI 53562-5531 Ph: Not Available | Matthew Erick Larson, 600 Highland Ave, Madison, WI 53792-0001 Ph: (608) 263-6400 |