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MADELINE HAE SHIN LUNDGREN PA
NPI 1265161699
Physician Assistant in Lodi, CA

Active since June 09, 2022PECOS EnrolledAccepts Medicare Assignment
975 S FAIRMONT AVE, LODI, CA 95240(209) 334-3411 Get Directions Write a Review

NPPES record last updated: June 20, 2022. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Madeline Hae Shin Lundgren Pa NPPES

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

MADELINE HAE SHIN LUNDGREN PA (NPI 1265161699) is an individual physician assistant in Lodi, California and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1265161699
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMADELINE HAE SHIN LUNDGRENCredential: PA
Location Address975 S FAIRMONT AVELodi, CA 95240-5118
Mailing Address2736 River Cove DrRiverbank, CA 95367-3319
Phone(209) 334-3411
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 9, 2022
Last NPPES UpdateJune 20, 2022
NPPES CertifiedJune 20, 2022
✔ NPI 1265161699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
975 S FAIRMONT AVE, Lodi, CA 95240
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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

Madeline Hae Shin Lundgren Pa 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 ID6709267693
PECOS Enrollment IDI20220725000971
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 5

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.
38 services38 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
36 services34 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
22 services22 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
15 services15 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.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95240 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

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.

TERI SPRING RD
Dietitian, Registered
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 334-3411
DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC
Pathology (Anatomic Pathology & Clinical Pathology)
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (916) 447-6267
DR. KEVIN EARL RABEY M.D.
Emergency Medicine
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 334-3411
ARIANNA BUSH
Physician Assistant
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 334-3411
LODI MEMORIAL HOSPTIAL PHARMACY WEST
Pharmacy (Clinic Pharmacy)
975 S FAIRMONT AVE, 2415 W VINE #104
LODI, CA 95240
San Joaquin County (209) 334-3411
MRS. KRISTINA FORTES FNP, MSN, RN
Nurse Practitioner (Family)
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 334-3411
ADAM JOSEPH WOODYARD DO
Radiology (Diagnostic Radiology)
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 334-3411
LANCY LU
Pediatrics
975 S FAIRMONT AVE
LODI, CA 95240
San Joaquin County (209) 339-7639

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 Madeline Lundgren's NPI number?

The NPI number for Madeline Lundgren is 1265161699. It was assigned to this individual provider in the NPPES registry on June 9, 2022.

Where is Madeline Lundgren located?

Madeline Lundgren practices at 975 S Fairmont Ave, Lodi, CA 95240. The listed phone number is (209) 334-3411.

What is Madeline Lundgren's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Madeline Lundgren enrolled in Medicare?

Yes. Madeline Lundgren 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.

When was this NPI record last updated?

The NPPES record for Madeline Lundgren was last updated on June 20, 2022. 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.