JAMES D LARSON M.D.
NPI 1164632410
Surgery in Grafton, WI

Active since May 23, 2007PECOS EnrolledAccepts Medicare Assignment
975 PORT WASHINGTON RD, SUITE 320, GRAFTON, WI 53024(262) 329-8100 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 13, 2025, Nov 22, 2021 (2 updates tracked since 2021).

About James D Larson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES D LARSON M.D. (NPI 1164632410) is an individual surgery provider in Grafton, Wisconsin, licensed in Wisconsin (60324) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Center, and is a graduate of Medical College Of Wisconsin (2007).

NPPES Registry Identity

NPI1164632410
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJAMES D LARSONCredential: M.D.
Location Address975 PORT WASHINGTON RD, SUITE 320Grafton, WI 53024-9201
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 2007
Enumeration DateMay 23, 2007
Last NPPES UpdateJune 13, 20252 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
✔ NPI 1164632410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in WI · 60324
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
975 PORT WASHINGTON RD, Grafton, WI 53024

Other Identifiers 2

Medicaid100030318WI
OtherC7-0003751DE · Acgme Training License

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James D Larson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537317946
PECOS Enrollment IDI20130806000132
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show James Larson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family Medicine
3003 W GOOD HOPE RD
Milwaukee, WI 53209
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,615 clinicians in this Medicare group
Obstetrics & Gynecology
8905 W LINCOLN AVE, SUITE 515
West Allis, WI 53227
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
General Acute Care Hospital
5000 MEMORIAL DR
Two Rivers, WI 54241
  • Reassigned Medicare billing, Wisconsin enrollment
  • 55 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
99 services99 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
47 services42 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
43 services22 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
35 services35 patients
Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032
This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora Medical Center

Acute Care Hospitals · Grafton, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520207
Location975 Port Washington RoadGrafton, WI 53024 · Ozaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53024 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
2 suppliers16 claims320 services$8.44 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
2 suppliers16 claims320 services$3.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Nurse Practitioner (Acute Care)
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Pharmacist
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Physician Assistant
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Internal Medicine (Interventional Cardiology)
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Nurse Practitioner
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Hospitalist
975 PORT WASHINGTON RD
GRAFTON, WI 53024
Speech-Language Pathologist
975 PORT WASHINGTON RD
GRAFTON, WI 53024

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Larson's NPI number?

The NPI number for James Larson is 1164632410. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is James Larson located?

James Larson practices at 975 Port Washington Rd Suite 320, Grafton, WI 53024. The listed phone number is (262) 329-8100.

What is James Larson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is James Larson enrolled in Medicare?

Yes. James Larson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for James Larson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Larson reassigns Medicare benefits to 3 organizations: Aurora Advanced Healthcare, Inc. (Milwaukee, WI), Aurora Medical Group, Inc. (West Allis, WI) and Aurora Health Care North, Inc. (Two Rivers, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Larson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Larson accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list James Larson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Larson affiliated with any hospitals?

According to CMS data, James Larson is affiliated with Aurora Medical Center.

When was this NPI record last updated?

The NPPES record for James Larson was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.