Individual provider Active NPI

Madison Kerzel, PA

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1144062142
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2925 Ryan Dr SE
Salem, OR 97301-9687
Phone
(503) 399-1262
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 Primary

Addresses

Primary practice location

2925 Ryan Dr SE
Salem, OR 97301-9687

Mailing address

4016 Cloudview Dr S
Salem, OR 97302-2776
Phone (503) 881-9812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240918004297 OR Practitioner - Physician Assistant 6800337791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Radiology Consultants PCGroup PAC ID 0446148498, 33 clinicians

Practice addresses (Care Compare)

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 399-1262

525 SE Washington St
Dallas, OR 97338-2834
Phone (503) 623-7302

7021 SW Canyon CRST
Portland, OR 97225-3622
Phone (844) 825-9300

800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC CurrentSince Sep 30, 2024 Accepting new patients
Salem Imaging LLC Past Accepting new patients
Salem Health Past Accepting new patients

Locations

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

2925 Ryan Dr SE
Salem, OR 97301
Phone (503) 399-1262

Interoperability endpoints

  • Direct secure messaging: mkerzel394048@direct.salemhealth.org

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.

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1144062142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 CLOUDVIEW DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022776",
            "telephone_number": "503-881-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERZEL",
        "first_name": "MADISON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.