Individual provider Active NPI

Brent L Madsen, PA-C

  • Physician Assistant
  • Tempe, AZ
National Provider Identifier
1003897661
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
631 Issued in NE
Practice address
914 N Scottsdale Rd Ste 104
Tempe, AZ 85288-2116
Phone
(480) 924-8382
Fax
(480) 966-0566
NPI assigned
Nov 10, 2005
Last updated
May 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9900 AZ
Physician Assistant 363A00000X 5119 OK
Physician Assistant 363A00000X 631 NE Primary
Family Medicine Physician 207Q00000X 631 NE

Addresses

Primary practice location

914 N Scottsdale Rd Ste 104
Tempe, AZ 85288-2116

Mailing address

120 Park Ave
Hebron, NE 68370-2019
Phone (402) 768-7203

Other practice location 1

16205 N Pennsylvania Ave
Edmond, OK 73013-7325
Phone (405) 705-5700

Other identifiers 1

IdentifierTypeStateIssuer
508944155MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, AZ, OK3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100610000245 NE Practitioner - Physician Assistant 4789714205 Reassigns benefits to 3 organizations
I20240104002390 AZ Practitioner - Physician Assistant 4789714205 Reassigns benefits to 2 organizations
I20240108005246 OK Practitioner - Physician Assistant 4789714205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

914 N Scottsdale Rd
Suite 104
Tempe, AZ 85288-2116
Phone (480) 924-8382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9900AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Turn Lane PC Family Medicine CurrentSince Nov 2, 2013 Accepting new patients
Thayer County Memorial Hospital Past Accepting new patients

Locations

8419 S 73rd Plz
Ste 101
Papillion, NE 68046
Phone (402) 991-9060

309 S Lincoln Ave
York, NE 68467
Phone (402) 720-9986

Interoperability endpoints

  • Direct secure messaging: brent.madsenpac.p1@direct.nextcare.nextgenshare.com
  • Direct secure messaging: brent.madsenpac.p10@direct.nextcare.nextgenshare.com
  • Direct secure messaging: brent.madsenpac.p8@direct.nextcare.nextgenshare.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/6aeeb1a0-1a0d-40b6-a477-0bb70c9416f3/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1003897661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PARK AVE",
            "city": "HEBRON",
            "state": "NE",
            "postal_code": "683702019",
            "telephone_number": "402-768-7203",
            "fax_number": "402-768-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N SCOTTSDALE RD STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852882116",
            "telephone_number": "480-924-8382",
            "fax_number": "480-966-0566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16205 N Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730137325",
            "country_code": "US",
            "telephone_number": "405-705-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "BRENT",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5119",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "631",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "631",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508944155",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.