Individual provider Active NPI

Madison Elizabeth Lusby, PA-C

  • Physician Assistant
  • Edgewood, KY
National Provider Identifier
1366252751
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3600 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-2000
Fax
(859) 301-6910
NPI assigned
Jan 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 PA3600 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 344-5555

Other names 1

  • Madison Fentress Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250123002385 KY Practitioner - Physician Assistant 9335678143 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
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2237

7683 Mall Rd
Unit B
Florence, KY 41042-1590
Phone (859) 817-1320

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

7388 Turfway Rd
Florence, KY 41042
Phone (606) 331-9000

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

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 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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1366252751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2000",
            "fax_number": "859-301-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSBY",
        "first_name": "MADISON",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "FENTRESS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.