TODD ROBERT LARSON D.O.
NPI 1609184365
Ophthalmology in Sheboygan, WI

Active since September 15, 2010PECOS EnrolledAccepts Medicare Assignment
71.87/100
CMS Quality Rating
1442 N 31ST ST, SHEBOYGAN, WI 53081(920) 452-5400(920) 452-1920 Get Directions Write a Review

NPPES record last updated: December 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Todd Robert Larson D.o. NPPES

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

TODD ROBERT LARSON D.O. (NPI 1609184365) is an individual ophthalmology provider in Sheboygan, Wisconsin, licensed in Wisconsin (55136-021) and active in the NPI registry since September 2010. He is enrolled in Medicare PECOS, is affiliated with St Nicholas Hospital, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2007).

NPPES Registry Identity

NPI1609184365
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTODD ROBERT LARSONCredential: D.O.
Location Address1442 N 31ST STSheboygan, WI 53081-3061
Mailing Address1442 N 31st StSheboygan, WI 53081-3061 · (920) 452-5400 · Fax (920) 452-1920
Fax(920) 452-1920
Sole ProprietorNo
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2007
Enumeration DateSeptember 15, 2010
Last NPPES UpdateDecember 16, 2021
NPPES CertifiedDecember 16, 2021
NPI 1609184365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in WI · 55136-021
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1442 N 31ST ST, Sheboygan, WI 53081

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Todd Robert Larson D.o. 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 ID4385829092
PECOS Enrollment IDI20110701000342
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.

Areas of Expertise CMS Part B claims 16

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
402 services140 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
359 services277 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
312 services39 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
252 services55 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
168 services135 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.
121 services79 patients

Hospital Affiliations CMS Care Compare

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

71.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.64
Promoting Interoperability50
Improvement Activities40
Cost49.26

Other Providers at the Same Location NPPES 15

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

Ophthalmology
1442 N 31ST ST
SHEBOYGAN, WI 53081
Optometrist
1442 N 31ST ST
SHEBOYGAN, WI 53081
Audiologist
1442 N 31ST ST
SHEBOYGAN, WI 53081
Eyewear Supplier
1442 N 31ST ST
SHEBOYGAN, WI 53081
Audiologist
1442 N 31ST ST
SHEBOYGAN, WI 53081
Audiologist-Hearing Aid Fitter
1442 N 31ST ST
SHEBOYGAN, WI 53081
Audiologist
1442 N 31ST ST
SHEBOYGAN, WI 53081
Ophthalmology
1442 N 31ST ST
SHEBOYGAN, WI 53081

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 Todd Larson's NPI number?

The NPI number for Todd Larson is 1609184365. It was assigned to this individual provider in the NPPES registry on September 15, 2010.

Where is Todd Larson located?

Todd Larson practices at 1442 N 31st St, Sheboygan, WI 53081. The listed phone number is (920) 452-5400.

What is Todd Larson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Todd Larson enrolled in Medicare?

Yes. Todd 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.

What insurance does Todd Larson accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Network Health, Providence Health Plan and Quartz and 1 other insurer list Todd 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 Todd Larson affiliated with any hospitals?

According to CMS data, Todd Larson is affiliated with St Nicholas Hospital.

When was this NPI record last updated?

The NPPES record for Todd Larson was last updated on December 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.