Derald L. Madson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

35059388 Issued in OH

Practice address

3964 Frazeysburg Rd
Zanesville, OH 43701-8924

Phone

(740) 455-4944

Fax

(740) 450-6199

NPI assigned

Jun 13, 2005

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 3

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derald.madson.1@19363.direct.athenahealth.com

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.

• Sumner Physician Practices LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Gallatin, TN
  • NPI 1720572209
  Medicare reassignment NPD
• Sumner Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Gallatin, TN
  • NPI 1083953848
  NPD
• Sumner Physician Practices, LLC

  • Interventional Cardiology Physician
  • Gallatin, TN
  • NPI 1417782194
  NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1598769077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 FRAZEYSBURG RD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437018924",
            "telephone_number": "740-455-4944",
            "fax_number": "740-450-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 FRAZEYSBURG RD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437018924",
            "telephone_number": "740-455-4944",
            "fax_number": "740-450-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSON",
        "first_name": "DERALD",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35059388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "311661239026",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000122822",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2131955",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Lynn
• Jennifer L. Machmer, MSW ,QMHS
• Valerie Sue Mack, R.N.
• Johnathan Micheal Maclean
• Sarah Judis Maclean, DMD
• Krishenclai Krissy Maharaj
• Jennifer W Mahon
• Robert J. Malek, D.D.S.
• Candy Christine Mallett
• Jane Marie Malloy, AAB, QMHS

• Vascular Surgery Physician in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Vascular Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.