MADELINE MCCLAIN LUCILLE MACARTHUR PA
NPI 1629702188
Physician Assistant - Medical in Lexington, KY

NPI Status: Active since July 12, 2022

Contact Information

1306 VERSAILLES RD STE 120
LEXINGTON, KY
ZIP 40504
Phone: (859) 259-2635

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  • Individual
  • Female
  • Years of Experience 4
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MADELINE MACARTHUR

This page provides the complete NPI Profile along with additional information for Madeline Macarthur, a primary care provider established in Lexington, Kentucky with a medical specialization in Physician Assistant, focusing in medical and more than 4 years of experience. She graduated from Lincoln Memorial University Medical Department in 2022. The healthcare provider is registered in the NPI registry with number 1629702188 assigned on July 2022. The practitioner's primary taxonomy code is 363AM0700X. The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1629702188
Provider Name
MADELINE MCCLAIN LUCILLE MACARTHUR PA
Gender
Female
Entity Type
Individual
Location Address
1306 VERSAILLES RD STE 120 LEXINGTON, KY 40504
Location Phone
(859) 259-2635
Mailing Address
1306 VERSAILLES RD STE 120 LEXINGTON, KY 40504
Mailing Phone
(859) 259-2635
Medical School Name
LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduation Year
2022
Is Sole Proprietor?
No
Enumeration Date
07-12-2022
Last Update Date
01-30-2023
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A primary care provider (PCP) like Madeline Macarthur sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Madeline Macarthur is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Madeline Macarthur is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8729451299

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20230302002816

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Madeline Macarthur is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SAINT JOSEPH EAST150 NORTH EAGLE CREEK DRIVE
LEXINGTON, KY 40509
(859) 967-5000Acute Care Hospitals

Reviews for MADELINE MCCLAIN LUCILLE MACARTHUR PA

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629702188, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 7 → 14 → 5 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 1 + 4 + 0 + 4 + 1 + 1 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1629702188.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Family Medicine
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Counselor (Professional)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner (Family)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Physician Assistant
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Physician Assistant
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Internal Medicine
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner (Family)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Physician Assistant
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner (Adult Health)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner (Psychiatric/Mental Health)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Nurse Practitioner (Psychiatric/Mental Health)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504
Social Worker (Clinical)
1306 VERSAILLES RD STE 120
LEXINGTON, KY 40504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629702188, enumerated as an "individual" on July 12, 2022.

The provider is located at 1306 VERSAILLES RD STE 120 LEXINGTON, KY 40504 and the phone number is (859) 259-2635.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.

Madeline Macarthur is affiliated with: SAINT JOSEPH EAST.