Madison Elizabeth Amos, PA-C
Individual provider Active NPI Surgical Physician Assistant · Norwalk, CT
NPI 1477067239 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1477067239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 5030 (CT)
- Practice address
- 761 Main Ave Ste 102
Norwalk, CT 06851-1080 - Phone
- (203) 810-4151
- NPI assigned
- Nov 30, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Greenbrae Dermatology, a Medical Corporation
Practice addresses (Care Compare)
1300 S Eliseo Dr
Suite 207
Greenbrae, CA 94904-2015
Phone (415) 925-0550
501 Sir Francis Drake Blvd
Suite 200
Greenbrae, CA 94904-2305
Phone (415) 925-0550
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.34 of 100
- Quality
- 90.85
- Promoting interoperability
- 87
- Improvement activities
- 40
- Cost
- 71.11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711003158 | CA | Practitioner - Physician Assistant | 7315206778 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62769 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Valley Center for Dermatology LLC | Past | Accepting new patients |
Interoperability endpoints
- mamos@directaddress.net
- https://api.platform.athenahealth.com/2831/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0005175 | CO | |
| Surgical Physician Assistant | 363AS0400X | 5030 | CT | Yes |
| Physician Assistant | 363A00000X | 62769 | CA |
Addresses
Primary practice location
761 Main Ave Ste 102
Norwalk, CT 06851-1080
Mailing address
761 Main Ave Ste 102
Norwalk, CT 06851-1080
Other practice location 1
1610 Prairie Center Pkwy Ste 2230
Brighton, CO 80601-4008
Phone (303) 604-1444
Other practice location 2
5420 Arapahoe Ave Ste A
Boulder, CO 80303-1250
Phone (303) 604-1444
Other practice location 3
1140 W South Boulder Rd Ste 202
Lafayette, CO 80026-8910
Phone (303) 604-1444
Other practice location 4
2420 Samaritan Dr
San Jose, CA 95124-3907
Phone (408) 369-5600
Other practice location 5
501 S Shore Ctr W Ste 103A
Alameda, CA 94501-5762
Phone (510) 227-7028
Other practice location 6
2001 Union St Ste 520
San Francisco, CA 94123-4110
Phone (415) 922-3344
Other providers in Norwalk, CT
- Valentina Amelio
- American Day CD Centers, L.L.C.
- Americares Free Clinic of Norwalk
- Nilesh Harshad Amin
- Esla Aminlewis
- Anasta Kydes-Harmony of the Mind, Body, & Soul LLC
- Michael Marion Ancuta
- Renate Anderson
- Sue Anderson
- Sevim Andirin
All providers in Norwalk, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.