Individual provider Active NPI

Nikole L. Maddes, PA

  • Physician Assistant
  • Fraser, MI
National Provider Identifier
1811254634
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17717 Masonic
Fraser, MI 48026-3158
Phone
(586) 294-0600
Fax
(586) 294-2525
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 Primary

Addresses

Primary practice location

17717 Masonic
Fraser, MI 48026-3158

Mailing address

17717 Masonic
Fraser, MI 48026-3158
Phone (586) 294-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120824000833 MI Practitioner - Physician Assistant 1658528708 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

28284 Dequindre Rd
Warren, MI 48092-5604
Phone (586) 413-7069

309 E 11 Mile Rd
Beaumont Urgent Care of Michigan
Royal Oak, MI 48067-2735
Phone (248) 965-8806

43037 Dequindre Rd
Troy, MI 48085-1101
Phone (248) 817-8682

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Urgent Care PC CurrentSince May 1, 2015 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients

Locations

51850 Dequindre Rd
Ste 1
Shelby Township, MI 48316
Phone (586) 799-4082

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 3

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1811254634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17717 MASONIC",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263158",
            "telephone_number": "586-294-0600",
            "fax_number": "586-294-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17717 MASONIC",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263158",
            "telephone_number": "586-294-0600",
            "fax_number": "586-294-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDES",
        "first_name": "NIKOLE",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fraser, MI

Sources for this page

Verify at the official NPI Registry.