MICHAEL WAYNE MADSEN M.D.
NPI 1043430911
Orthopaedic Surgery in Smithfield, NC

Q: What is Michael Madsen's NPI number?

The NPI number for Michael Madsen is 1043430911. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Q: What is Michael Madsen's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Madsen was last updated on December 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2007PECOS EnrolledAccepts Medicare Assignment

88.4/100

CMS Quality Rating

100 KELLIE DR, SMITHFIELD, NC 27577(919) 934-1094 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 20, 2021, Jun 3, 2021, Jan 19, 2021 and 3 more (6 updates tracked since 2020).

On this page

About Michael Wayne Madsen M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL WAYNE MADSEN M.D. (NPI 1043430911) is an individual orthopaedic surgery provider in Smithfield, North Carolina, licensed in North Carolina (2021-01570) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with North Carolina Specialty Hospital, and is a graduate of Columbia University College Of Physicians And Surgeons (2000).

NPPES Registry Identity

NPI1043430911

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameMICHAEL WAYNE MADSENCredential: M.D.

Location Address100 KELLIE DRSmithfield, NC 27577-9444

Mailing Address120 William Penn PlzDurham, NC 27704-2150 · (919) 220-5255 · Fax (919) 220-6379

Phone(919) 934-1094

Sole ProprietorNo

Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 2000

Enumeration DateApril 26, 2007

Last NPPES UpdateDecember 20, 20216 updates tracked since enumeration

NPPES CertifiedDecember 20, 2021

✔ NPI 1043430911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NC · 2021-01570

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 45364 (CO)

100 KELLIE DR, Smithfield, NC 27577

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Wayne Madsen M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608805643

PECOS Enrollment IDI20210803003340

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Michael Madsen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Emergeortho PA

48 mi

Orthopaedic Surgery

120 WILLIAM PENN PLZ
Durham, NC 27704

Reassigned Medicare billing, North Carolina enrollment
300 clinicians in this Medicare group

NPI 1376592964 (919) 220-5255

Colorado Orthopaedics PC

1,478 mi

Orthopaedic Surgery

10535 PARK MEADOWS BLVD, SUITE 301
Lone Tree, CO 80124

Reassigned Medicare billing, Colorado enrollment
11 clinicians in this Medicare group

NPI 1467745570 (303) 662-8250

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

249 services205 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

204 services171 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

88 services86 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

70 services55 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

63 services63 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

56 services56 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

49 services28 patients

X-ray of lower and sacral spine, 2-3 views 72100

35 services35 patients

Computer-assisted spinal procedure 61783

A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.

30 services29 patients

Aspiration of bone marrow for spine bone graft 20939

Aspiration of bone marrow for spine bone graft is a procedure where a small amount of bone marrow is extracted, usually from the hip, and then used to help new bone grow in the spine. This can aid in spinal fusion surgeries, enhancing recovery and stability.

26 services26 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

26 services26 patients

Fusion of spine in lower back with partial removal of spine bone and disc 22633

This procedure, called lumbar spinal fusion, involves joining two or more vertebrae in your lower back. It includes a partial removal of a spine bone and disc to alleviate pain and improve stability. The goal is to reduce motion between vertebrae and prevent nerve irritation.

23 services23 patients

Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back 63052

This procedure involves the partial removal of a bone segment in your lower back to relieve pressure on your spinal cord or nerves. It's usually done during a spinal fusion in the lower back, which helps to stabilize your spine by joining two or more vertebrae together.

22 services22 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

22 services19 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

22 services21 patients

Fusion of additional segment of spine with partial removal of spine bone and disc 22634

This procedure involves merging an extra part of your spine with a partial removal of your spine bone and disc. It's done to provide stability, reduce pain, and correct deformities. It's like creating a natural bridge of bone that stabilizes the spine.

17 services11 patients

Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back 63053

This procedure involves partially removing a bone section in the lower back to relieve pressure on the spinal cord or nerves. It's performed during a spinal fusion, where bones in the lower back are joined to improve stability and reduce pain.

17 services11 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

16 services16 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

13 services13 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Carolina Specialty Hospital

Acute Care Hospitals · Durham, NC

OwnershipProprietary

CMS Certification Number340049

Location3916 Ben Franklin BoulevardDurham, NC 27704 · Durham County

Johnston Health

Acute Care Hospitals · Smithfield, NC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340090

Location509 Bright Leaf BlvdSmithfield, NC 27577 · Johnston County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27577 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.4/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

94.91

Promoting Interoperability

Improvement Activities

Cost

67.25

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY LOUISE DOWTY PA-C

Physician Assistant