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

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: July 26, 2026.

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

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
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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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
Quality94.91
Promoting Interoperability99
Improvement Activities40
Cost67.25

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.

Physician Assistant
100 KELLIE DR
SMITHFIELD, NC 27577
Physician Assistant
100 KELLIE DR
SMITHFIELD, NC 27577
Orthopaedic Surgery
100 KELLIE DR
SMITHFIELD, NC 27577
Physical Therapist
100 KELLIE DR
SMITHFIELD, NC 27577
Physician Assistant
100 KELLIE DR
SMITHFIELD, NC 27577
Physician Assistant
100 KELLIE DR
SMITHFIELD, NC 27577
Orthopaedic Surgery (Hand Surgery)
100 KELLIE DR
SMITHFIELD, NC 27577
Physician Assistant
100 KELLIE DR
SMITHFIELD, NC 27577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Michael Madsen located?

Michael Madsen practices at 100 Kellie Dr, Smithfield, NC 27577. The listed phone number is (919) 934-1094.

What is Michael Madsen's specialty?

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

Is Michael Madsen enrolled in Medicare?

Yes. Michael Madsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Madsen accept?

Health plans from Blue Cross and Blue Shield of NC list Michael Madsen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Madsen affiliated with any hospitals?

According to CMS data, Michael Madsen is affiliated with North Carolina Specialty Hospital and Johnston Health.

When was this NPI record last updated?

The NPPES record for Michael Madsen was last updated on December 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.