Individual provider Active NPI

Samuel Leathen Madson, M.D.

  • Diagnostic Radiology Physician
  • Usaf Academy, CO
National Provider Identifier
1699064220
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0075886 Issued in CO
Practice address
4102 Pinion Dr
Usaf Academy, CO 80840-2502
Phone
(760) 819-1136
NPI assigned
Apr 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 27143 NE
Diagnostic Radiology Physician 2085R0202X DR.0075886 CO Primary
Diagnostic Radiology Physician 2085R0202X T9941 TX

Addresses

Primary practice location

4102 Pinion Dr
Usaf Academy, CO 80840-2502

Mailing address

4218 Manitou Bay
San Antonio, TX 78259-2278
Phone (210) 577-0533

Other practice location 1

2001 N Jefferson Ave
Mount Pleasant, TX 75455-2338
Phone (903) 577-6000

Other practice location 2

12738 Mission Meadow Dr
Colorado Springs, CO 80921-7659
Phone (210) 577-0533

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607003394 TX Practitioner - Diagnostic Radiology 9436516390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Titus County Hospital DistrictGroup PAC ID 0143203257, 107 clinicians

Practice addresses (Care Compare)

2001 N Jefferson Ave
Mt Pleasant, TX 75455-2338
Phone (903) 577-6000

Hospital & facility affiliations

  • Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0075886COMDDiagnostic Radiology Physician
27143NEMDDiagnostic Radiology Physician
T9941TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Titus County Hospital District CurrentSince Aug 3, 2023 Accepting new patients
Titus County Hospital District CurrentSince Aug 3, 2023 Accepting new patients

Locations

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1699064220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 MANITOU BAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592278",
            "telephone_number": "210-577-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "760-819-1136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "TX",
            "postal_code": "754552338",
            "country_code": "US",
            "telephone_number": "903-577-6000",
            "fax_number": "903-577-6245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12738 Mission Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809217659",
            "country_code": "US",
            "telephone_number": "210-577-0533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADSON",
        "first_name": "SAMUEL",
        "middle_name": "LEATHEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "27143",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0075886",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "T9941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

Verify at the official NPI Registry.