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ARTHUR C. MADSEN M.D.
NPI 1699745711
Internal Medicine in Vernal, UT

Active since January 23, 2006PECOS Enrolled
19.58/100
CMS Quality Rating
175 NORTH 100 WEST, STE 205-B, VERNAL, UT 84078(435) 789-6400(435) 789-6040 Get Directions Write a Review

NPPES record last updated: November 6, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Arthur C. Madsen M.d. NPPES

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

ARTHUR C. MADSEN M.D. (NPI 1699745711) is an individual internal medicine provider in Vernal, Utah, licensed in Utah (171234-1205) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Uintah Basin Medical Center, and is a graduate of University Of Utah School Of Medicine (1984).

NPPES Registry Identity

NPI1699745711
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameARTHUR C. MADSENCredential: M.D.
Location Address175 NORTH 100 WEST, STE 205-BVernal, UT 84078-2053
Mailing Address175 North 100 West, Ste 205-bVernal, UT 84078-2053 · (435) 789-6400 · Fax (435) 789-6040
Phone(435) 789-6400
Fax(435) 789-6040
Sole ProprietorYes
Medical School CMSUniversity Of Utah School Of MedicineGraduated 1984
Enumeration DateJanuary 23, 2006
Last NPPES UpdateNovember 6, 2017
✔ NPI 1699745711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in UT · 171234-1205✔ Licensed in UT · 841712341205
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
175 NORTH 100 WEST, Vernal, UT 84078
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Other Identifiers 4

Medicare UPINC63655
Medicare ID-Type Unspecified000002645
Medicaid07738UT
Medicare PIN000002645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah 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 (PECOS)

Arthur C. Madsen M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991727794
PECOS Enrollment IDI20051221000324
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 7

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.
490 services163 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
135 services65 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
98 services98 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
80 services80 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
51 services51 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.
22 services20 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

19.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost65.28

Referred Medical Equipment & Supplies CMS DME claims 16

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers41 claims147 services$5.98 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers14 claims14 services$42.98 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers21 claims21 services$107.33 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers14 claims35 services$39.87 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers12 claims12 services$72.36 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers22 claims22 services$19.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Arthur Madsen's NPI number?

The NPI number for Arthur Madsen is 1699745711. It was assigned to this individual provider in the NPPES registry on January 23, 2006.

Where is Arthur Madsen located?

Arthur Madsen practices at 175 North 100 West Ste 205-B, Vernal, UT 84078. The listed phone number is (435) 789-6400.

What is Arthur Madsen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Arthur Madsen enrolled in Medicare?

Yes. Arthur Madsen is registered in the Medicare PECOS enrollment system.

What insurance does Arthur Madsen accept?

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

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

When was this NPI record last updated?

The NPPES record for Arthur Madsen was last updated on November 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.