Individual provider Active NPI

Madyson Brown, PA-C

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1104604800
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012027 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-1000
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 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 5601012027 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

4325 Lavender LN
Dewitt, MI 48820-7996

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
I20231012000883 MI Practitioner - Physician Assistant 5092160952 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Oct 1, 2023 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Oct 1, 2023 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1140 E Michigan Ave
Ste 300
Lansing, MI 48912
Phone (517) 364-5200

1200 E Michigan Ave
Ste 775
Lansing, MI 48912
Phone (517) 364-5160

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1104604800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LAVENDER LN",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MADYSON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.