Kyle Anthony Larson, DPT is a medicare enrolled "Physical Therapist" provider in Clear Lake, Wisconsin. He graduated from medical school in 2020 and has 5 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Clear Lake Physical Therapy And Rehab Specialists Llc and his current practice location is
417 3rd Avenue, Clear Lake, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 263-4103.
Kyle Anthony Larson is licensed to practice in Wisconsin (license number 14996-24) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1245853175.
Healthcare Provider's Profile
| Full Name | Kyle Anthony Larson |
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| Gender | Male |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 5 Years |
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| Location | 417 3rd Avenue, Clear Lake, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kyle Anthony Larson graduated from medical school in 2020
NPI Data:
- NPI Number: 1245853175
- Provider Enumeration Date: 05/27/2020
- Last Update Date: 05/27/2020
Medicare PECOS Information:
- PECOS PAC ID: 0042631822
- Enrollment ID: I20200603000970
Medical Identifiers
Medical identifiers for Kyle Anthony Larson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245853175 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 14996-24 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Clear Lake Physical Therapy And Rehab Specialists Llc | 0749327526 | 5 |
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. Kyle Anthony Larson allows following entities to bill medicare on his behalf.
| Provider Name | Clear Lake Physical Therapy And Rehab Specialists Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1083845754
PECOS PAC ID: 0749327526
Enrollment ID: O20091027000797 |
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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. Kyle Anthony 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 |
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Kyle Anthony Larson, DPT
Po Box 147,
Clear Lake, WI 54005-0147
Ph: (715) 263-4103 | Kyle Anthony Larson, DPT
417 3rd Avenue,
Clear Lake, WI 54005-8905
Ph: (715) 263-4103 |
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