Individual provider Active NPI

Madison Shegos, PA-C

  • Physician Assistant
  • Fenton, MI
National Provider Identifier
1033824214
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011626 Issued in MI
Practice address
11228 Ridge View TRL
Fenton, MI 48430-2489
Phone
(810) 429-0656
NPI assigned
Jan 23, 2023
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011626 MI Primary

Addresses

Primary practice location

11228 Ridge View TRL
Fenton, MI 48430-2489

Mailing address

11228 Ridge View TRL
Fenton, MI 48430-2489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230227000396 MI Practitioner - Physician Assistant 7618340423 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

10785 S Saginaw St
Suite D
Grand Blanc, MI 48439-7003
Phone (810) 695-6337

1096 S Belsay Rd
Burton, MI 48509-1948

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys CurrentSince Sep 1, 2023 Accepting new patients
Genesys Practice Partners Inc CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Medical Group Genesys CurrentSince Sep 1, 2023 Accepting new patients
Genesys Practice Partners, Inc CurrentSince Nov 1, 2025 Accepting new patients
Genesys Practice Partners Inc Current Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients

Locations

1096 S Belsay Rd
Ste A
Burton, MI 48509
Phone (810) 742-6100

1460 N Center Rd
Burton, MI 48509
Phone (810) 424-2011

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

3399 Pollock Rd
Ste A
Grand Blanc, MI 48439
Phone (810) 606-7550

Interoperability endpoints

  • Direct secure messaging: madisonshegos@pmi.allscriptsdirect.net
  • Direct secure messaging: mshegos1151077@direct.hfhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1033824214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11228 RIDGE VIEW TRL",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11228 RIDGE VIEW TRL",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302489",
            "telephone_number": "810-429-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEGOS",
        "first_name": "MADISON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.