DR. ADAM MADSEN D.O.
NPI 1174843783
Orthopaedic Surgery in Vernal, UT

Active since June 04, 2010PECOS EnrolledAccepts Medicare Assignment
83.21/100
CMS Quality Rating
175 N 100 W, SUITE 204, VERNAL, UT 84078(435) 789-2060(435) 789-2071 Get Directions Write a Review

NPPES record last updated: March 31, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Adam Madsen D.o. NPPES

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

DR. ADAM MADSEN D.O. (NPI 1174843783) is an individual orthopaedic surgery provider in Vernal, Utah, licensed in Utah (9608322-1204) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Uintah Basin Medical Center, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1174843783
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. ADAM MADSENCredential: D.O.
Location Address175 N 100 W, SUITE 204Vernal, UT 84078-2033
Mailing Address175 N 100 W, Suite 204Vernal, UT 84078-2033
Fax(435) 789-2071
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJune 4, 2010
Last NPPES UpdateMarch 31, 2017
NPI 1174843783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in UT · 9608322-1204
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.

175 N 100 W, Vernal, UT 84078

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

Dr. Adam Madsen D.o. 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 ID8325286719
PECOS Enrollment IDI20160622002460
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 9

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.
209 services135 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
178 services82 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.
95 services67 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.
71 services71 patients
Injection, methylprednisolone acetate, 80 mg J1040
Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
51 services36 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.
21 services21 patients

Hospital Affiliations CMS Care Compare 2

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

Uintah Basin Medical Center

Acute Care Hospitals · Roosevelt, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number460019
Location250 West 300 NorthRoosevelt, UT 84066 · Duchesne County
Emergency services Birthing friendly

Ashley Regional Medical Center

Acute Care Hospitals · Vernal, UT
OwnershipProprietary
CMS Certification Number460030
Location150 West 100 NorthVernal, UT 84078 · Uintah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84078 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

83.21/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability98
Improvement Activities40
Cost45.71

Reported Quality Measures

Advance Care Plan
100%418 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%1,944 patients5/55-star benchmark: 100%
Falls: Plan of Care
100%66 patients
Falls: Screening for Future Fall Risk
100%406 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%1,036 patients5/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
98%421 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 430 patients
Patients totalRate: 0% · 430 patients
0%430 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers15 claims15 services$119.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

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

Pediatrics
175 N 100 W, STE 106
VERNAL, UT 84078
Obstetrics & Gynecology
175 N 100 W, STE 103
VERNAL, UT 84078
Family Medicine
175 N 100 W, SUITE 205
VERNAL, UT 84078
Surgery
175 N 100 W, STE 202
VERNAL, UT 84078
Obstetrics & Gynecology (Obstetrics)
175 N 100 W, SUITE 103
VERNAL, UT 84078
Orthopaedic Surgery
175 N 100 W, SUITE 204
VERNAL, UT 84078
Surgery
175 N 100 W, STE 202
VERNAL, UT 84078
Family Medicine
175 N 100 W, SUITE 205A
VERNAL, UT 84078

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 Adam Madsen's NPI number?

The NPI number for Adam Madsen is 1174843783. It was assigned to this individual provider in the NPPES registry on June 4, 2010.

Where is Adam Madsen located?

Adam Madsen practices at 175 N 100 W Suite 204, Vernal, UT 84078. The listed phone number is (435) 789-2060.

What is Adam Madsen's specialty?

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

Is Adam Madsen enrolled in Medicare?

Yes. Adam 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 Adam Madsen accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Adam 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 Adam Madsen affiliated with any hospitals?

According to CMS data, Adam Madsen is affiliated with Uintah Basin Medical Center and Ashley Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Adam Madsen was last updated on March 31, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.