Mark J. Madsen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10310 Issued in CA

Practice address

1409 E Briggsmore Ave
Modesto, CA 95355-2707

Phone

(209) 550-4725

NPI assigned

May 6, 2006

Last updated

Dec 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmadsenpac37095@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Gould Medical Foundation

  • Family Medicine Physician
  • Turlock, CA
  • NPI 1023065133
  NPD (past)

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1407805757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRIGGSMORE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552707",
            "telephone_number": "209-550-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "MARK",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA10310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA10310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Elena Madrigal
• Marisela Madrigal
• Valerie Madrigal
• Seny Madriz Fajardo
• Katherine Elizabeth Madsen, N.P.
• Nikki Madson
• Misao Emily Maeyama, MA, LPCC
• Sepideh Maftoun-Banankhah, MD
• Xochitl Magallan
• Mayra Alejandra Castellanos Magallanes

• Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.