MRS. MADELINE MCCLUER DICKERSON AG-ACNP
NPI 1104220029
Nurse Practitioner - Acute Care in Fort Worth, TX

Q: What is Madeline Dickerson's NPI number?

The NPI number for Madeline Dickerson is 1104220029. It was assigned to this individual provider in the NPPES registry on October 21, 2014.

Q: What is Madeline Dickerson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Active since October 21, 2014PECOS EnrolledAccepts Medicare Assignment

75.27/100

CMS Quality Rating

800 5TH AVE STE 500, FORT WORTH, TX 76104(817) 250-4280 Get Directions Write a Review

NPPES record last updated: February 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 21, 2022, Nov 29, 2021 (2 updates tracked since 2021).

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About Mrs. Madeline Mccluer Dickerson Ag-acnp NPPES

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

MRS. MADELINE MCCLUER DICKERSON AG-ACNP (NPI 1104220029) is an individual acute care provider in Fort Worth, Texas, licensed in Texas (AP126665) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1104220029

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameMRS. MADELINE MCCLUER DICKERSONCredential: AG-ACNP

Location Address800 5TH AVE STE 500Fort Worth, TX 76104-7304

Mailing Address800 5th Ave Ste 500Fort Worth, TX 76104-7304 · (817) 250-4280

Phone(817) 250-4280

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateOctober 21, 2014

Last NPPES UpdateFebruary 21, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 21, 2022

✔ NPI 1104220029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in TX · AP126665

800 5TH AVE STE 500, Fort Worth, TX 76104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Mrs. Madeline Mccluer Dickerson Ag-acnp 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 ID2769708346

PECOS Enrollment IDI20150225000958

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 3

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 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.

99 services93 patients

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.

70 services64 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.

34 services34 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

Most-billed visit code 99214

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.

75.27/100

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

Scored as part of a group practice

Quality

68.07

Promoting Interoperability

100

Improvement Activities

Cost

49.5

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.

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