Individual provider Active NPI

Madeleine Marie Wirth, PA-C

  • Physician Assistant
  • Zanesville, OH
National Provider Identifier
1063003176
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006840RX Issued in OH
Practice address
751 Forest Ave Ste 301
Zanesville, OH 43701-2875
Phone
(740) 455-4923
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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 50.006840RX OH Primary

Addresses

Primary practice location

751 Forest Ave Ste 301
Zanesville, OH 43701-2875

Mailing address

1662 Merganser Run Dr
Columbus, OH 43215-1080
Phone (740) 975-0602

Other practice location 1

1662 Merganser Run Dr
Columbus, OH 43215-1080
Phone (740) 975-0602

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL maddiewirth@gmail.com GENESIS HEALTHCARE SYSTEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210302002981 OH Practitioner - Physician Assistant 7012323835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

1246 Ashland Ave
Zanesville, OH 43701-2861

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4000

945 Bethesda Dr
Zanesville, OH 43701-1880

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006840RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group, LLC CurrentSince Apr 13, 2021 Accepting new patients
Genesis Medical Group LLC CurrentSince Apr 13, 2021 Accepting new patients
Genesis Primary Care Physicians LLC Past Accepting new patients

Locations

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

2904 Bell St
Zanesville, OH 43701
Phone (740) 586-6828

751 Forest Ave
Ste 301
Zanesville, OH 43701
Phone (740) 454-0804

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1063003176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 MERGANSER RUN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151080",
            "telephone_number": "740-975-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE STE 301",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012875",
            "telephone_number": "740-455-4923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1662 Merganser Run Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432151080",
            "country_code": "US",
            "telephone_number": "740-975-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "MADELEINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006840RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "maddiewirth@gmail.com",
            "affiliation": "Y",
            "affiliationName": "GENESIS HEALTHCARE SYSTEM",
            "address_1": "751 Forest Ave Ste 301",
            "city": "Zanesville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437012875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.