Individual provider Active NPI

Roman K Madsen, PA-S

  • Physician Assistant
  • Apache Junction, AZ
National Provider Identifier
1750784617
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6220 Issued in AZ
Practice address
625 N Plaza Dr
Apache Junction, AZ 85120-5501
Phone
(480) 278-3374
NPI assigned
Oct 6, 2014
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6220 AZ Primary

Addresses

Primary practice location

625 N Plaza Dr
Apache Junction, AZ 85120-5501

Mailing address

1185 W 1140 N
Provo, UT 84604-3011
Phone (480) 278-3374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160502002216 AZ Practitioner - Physician Assistant 8820397540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1185 S Redondo Ctr Dr
Suite 1
Yuma, AZ 85365-2036
Phone (833) 431-4449

980 E Mt Lemmon Rd
Oracle, AZ 85623
Phone (520) 892-9240

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health and Wellness, Inc. CurrentSince Dec 7, 2015 Accepting new patients
Horizon Health and Wellness, Inc. CurrentSince Dec 7, 2015 Accepting new patients
Horizon Health & Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients

Locations

477 E Broadway Ave
Apache Junction, AZ 85119
Phone (480) 474-5630

625 N Plaza Dr
Apache Junction, AZ 85120
Phone (480) 282-6278

210 E Cottonwood Ln
Casa Grande, AZ 85122
Phone (520) 836-1688

23 S McNab Pkwy
San Manuel, AZ 85631
Phone (520) 385-2234

22713 S Ellsworth Rd
Ste 101
San Tan Valley, AZ 85142
Phone (480) 474-5670

400 W Main St
Superior, AZ 85173
Phone (520) 689-2457

3180 E 40th St
Yuma, AZ 85365
Phone (928) 341-0335

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1750784617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 W 1140 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043011",
            "telephone_number": "480-278-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N PLAZA DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851205501",
            "telephone_number": "480-278-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "ROMAN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

Verify at the official NPI Registry.