Individual provider Active NPI

Madelin Rossi, PA

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1417652967
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17217 Issued in TX
Practice address
6606 36TH St
Lubbock, TX 79407-1812
Phone
(806) 869-6121
NPI assigned
Apr 4, 2023
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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 PA17217 TX Primary
Athletic Trainer 2255A2300X 2023 TX

Addresses

Primary practice location

6606 36TH St
Lubbock, TX 79407-1812

Mailing address

6606 36TH St
Lubbock, TX 79407-1812
Phone (806) 869-6121

Other names 1

  • Madi Rossi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231207002081 TX Practitioner - Physician Assistant 3173972759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 4284617507, 65 clinicians

Practice addresses (Care Compare)

11011 Slide Rd
Lubbock, TX 79424-2274
Phone (806) 775-8459

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17217TXMDPhysician Assistant

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.

Hospital & facility affiliations 5

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1417652967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6606 36TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794071812",
            "telephone_number": "806-869-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 36TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794071812",
            "telephone_number": "806-869-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSI",
        "first_name": "MADELIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17217",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "2023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADI",
            "last_name": "ROSSI",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.