Individual provider Active NPI

Madisen Ahlstrom, PA-C

  • Physician Assistant
  • Davenport, IA
National Provider Identifier
1255021770
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1228 E Rusholme St Ste 3020
Davenport, IA 52803-2467
Phone
(563) 421-7540
Fax
(563) 421-7549
NPI assigned
May 9, 2023
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

1228 E Rusholme St Ste 3020
Davenport, IA 52803-2467

Mailing address

1320 W Lombard St
Davenport, IA 52804-2029
Phone (563) 333-5827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250407002833 IA Practitioner - Physician Assistant 4082138466 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
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

4700 E 56TH St
Davenport, IA 52807-2904

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Current Accepting new patients
Genesis Health System CurrentSince Mar 17, 2025 Accepting new patients
Genesis Health System CurrentSince Sep 15, 2025 Accepting new patients
Genesis Health System CurrentSince Sep 15, 2025 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1228 E Rusholme St
Ste 3020
Davenport, IA 52803
Phone (563) 421-7540

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

1401 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

Organizations & group practices 6

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1255021770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W LOMBARD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042029",
            "telephone_number": "563-333-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 E RUSHOLME ST STE 3020",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032467",
            "telephone_number": "563-421-7540",
            "fax_number": "563-421-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLSTROM",
        "first_name": "MADISEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.