Individual provider Active NPI

Madison Ashley Ginis, PA-C

  • Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1144989310
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8919 Issued in AZ
Practice address
14940 W Indian School Rd Ste 400
Goodyear, AZ 85395-7307
Phone
(623) 265-6267
Fax
(623) 265-6307
NPI assigned
Dec 15, 2021
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AZ
Physician Assistant 363A00000X 8919 AZ Primary

Addresses

Primary practice location

14940 W Indian School Rd Ste 400
Goodyear, AZ 85395-7307

Mailing address

14940 W Indian School Rd Ste 400
Goodyear, AZ 85395-7307
Phone (623) 265-6267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220110001137 AZ Practitioner - Physician Assistant 2163814807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Laser Center PC a Professional Medical CorporationGroup PAC ID 9537181185, 81 clinicians

Practice addresses (Care Compare)

13613 W Camino del Sol
Suite 1
Sun City West, AZ 85375-4480
Phone (480) 757-9854

1840 Mesquite Ave
Lake Havasu City, AZ 86403-5771
Phone (928) 719-8400

6145 W Chandler Blvd
Suite 2
Chandler, AZ 85226-3434
Phone (480) 454-8744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8919AZMDDentist

Interoperability endpoints

  • Direct secure messaging: mginis@lalasercenter.emadirect.md

Organizations & group practices 1

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": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1144989310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14940 W INDIAN SCHOOL RD STE 400",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957307",
            "telephone_number": "623-265-6267",
            "fax_number": "623-265-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14940 W INDIAN SCHOOL RD STE 400",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957307",
            "telephone_number": "623-265-6267",
            "fax_number": "623-265-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINIS",
        "first_name": "MADISON",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.