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MICHAEL K. MCFADDEN M.D.
NPI 1437156189
Pain Medicine - Interventional Pain Medicine in Hawkinsville, GA

Active since July 07, 2005PECOS EnrolledAccepts Medicare Assignment
81.63/100
CMS Quality Rating
202 PERRY HWY STE 101, HAWKINSVILLE, GA 31036(478) 892-7246(478) 892-7247 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 6, 2023, Feb 23, 2021 (2 updates tracked since 2021).

About Michael K. Mcfadden M.d. NPPES

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

MICHAEL K. MCFADDEN M.D. (NPI 1437156189) is an individual interventional pain medicine provider in Hawkinsville, Georgia, licensed in Georgia (89324) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Twin Cities Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1437156189
Entity TypeIndividualMale
Primary Taxonomy208VP0014X
Provider Legal NameMICHAEL K. MCFADDENCredential: M.D.
Location Address202 PERRY HWY STE 101Hawkinsville, GA 31036-6748
Mailing Address3356 Vineville AveMacon, GA 31204-2328 · (478) 476-9886 · Fax (478) 476-9976
Phone(478) 892-7246
Fax(478) 892-7247
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1995
Enumeration DateJuly 7, 2005
Last NPPES UpdateFebruary 12, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2024
✔ NPI 1437156189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Licenses✔ Licensed in GA · 89324✔ Licensed in FL · ME166528
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
202 PERRY HWY STE 101, Hawkinsville, GA 31036
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13356 Vineville AveMacon, GA 31204-2328 · Phone (478) 476-9642 · Fax (478) 476-9976
Location 23810 Highway 90Pace, FL 32571-1014 · Phone (855) 527-7246 · Fax (833) 905-2461

Other Identifiers 3

Other458214Healthlink
Medicaid200318550AIN
Other000000185016Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Blue Cross and Blue Shield of Alabama 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

Michael K. Mcfadden 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 ID8820983877
PECOS Enrollment IDI20240215001239, I20240417001659
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 8

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.
672 services438 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.
480 services306 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
199 services177 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481
A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.
162 services143 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.
119 services119 patients
Injection, ketorolac tromethamine, per 15 mg J1885
Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.
44 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Hca Florida Twin Cities Hospital

Acute Care Hospitals · Niceville, FL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number100054
Location2190 Hwy 85 NNiceville, FL 32578 · Okaloosa County
Emergency services

Baptist Hospital

Acute Care Hospitals · Pensacola, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100093
Location123 Baptist WayPensacola, FL 32503 · Escambia County
Emergency services Birthing friendly

Gulf Breeze Hospital

Acute Care Hospitals · Gulf Breeze, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number100266
Location1110 Gulf Breeze PkwyGulf Breeze, FL 32561 · Santa Rosa County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31036 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

81.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.87
Improvement Activities40
Cost46.93

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%7,435 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
81%4,262 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%4,923 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
98%4,923 patients4/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
31%1,033 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
65%1,015 patients3/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 1,038 patients
46%557 patients2/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
48%1,139 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
36%113 patients3/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 3% · 145 patients
3%145 patients4/55-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.

Other Providers at the Same Location NPPES

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

TAYLOR REGIONAL HOSPITAL
Internal Medicine
202 PERRY HWY STE 101
HAWKINSVILLE, GA 31036
Pulaski County (478) 783-0200

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 Mcfadden's NPI number?

The NPI number for Michael Mcfadden is 1437156189. It was assigned to this individual provider in the NPPES registry on July 7, 2005.

Where is Michael Mcfadden located?

Michael Mcfadden practices at 202 Perry Hwy Ste 101, Hawkinsville, GA 31036. The listed phone number is (478) 892-7246.

What is Michael Mcfadden's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Michael Mcfadden enrolled in Medicare?

Yes. Michael Mcfadden 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 Mcfadden accept?

Health plans from Ambetter Health, Ambetter of Alabama, Blue Cross and Blue Shield of Alabama, CareSource and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Michael Mcfadden 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 Mcfadden affiliated with any hospitals?

According to CMS data, Michael Mcfadden is affiliated with Hca Florida Twin Cities Hospital, Baptist Hospital and Gulf Breeze Hospital.

When was this NPI record last updated?

The NPPES record for Michael Mcfadden was last updated on February 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.