Individual provider Active NPI

Madison Macaruso Wiggin, PA

  • Physician Assistant
  • East Providence, RI
National Provider Identifier
1639611262
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01413 Issued in RI
Practice address
1 Kettle Point Ave
East Providence, RI 02914-5375
Phone
(401) 457-1500
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT00376 RI
Pharmacy Technician 183700000X PH106006 RI
Physician Assistant 363A00000X PA01413 RI Primary

Addresses

Primary practice location

1 Kettle Point Ave
East Providence, RI 02914-5375

Mailing address

PO Box 1119
Providence, RI 02901-1119

Other names 1

  • Madison Macaruso Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20211216001549 RI Practitioner - Physician Assistant 8820489313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PH106006RIMDPharmacy Technician
AT00376RIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. CurrentSince Nov 8, 2021 Accepting new patients

Locations

10 Reservoir St
Ste 101
Mansfield, MA 02048
Phone (508) 618-7111

1 Kettle Point Ave
East Providence, RI 02914
Phone (401) 330-1400

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

Interoperability endpoints

  • Direct secure messaging: madison.macaruso.1@13709.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1639611262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KETTLE POINT AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145375",
            "telephone_number": "401-457-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGIN",
        "first_name": "MADISON",
        "middle_name": "MACARUSO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "RI",
            "license": "AT00376",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "RI",
            "license": "PH106006",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "MACARUSO",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.