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MADISON RICKETTS
NPI 1700629862
Physician Assistant - Medical in Rochester, NY

Active since June 17, 2024PECOS EnrolledAccepts Medicare Assignment
1415 PORTLAND AVE STE 400, ROCHESTER, NY 14621(585) 922-4200(585) 922-4922 Get Directions Write a Review

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

Record update history: Mar 31, 2026, Feb 4, 2026, Oct 2, 2024 and 2 more (5 updates tracked since 2024).

About Madison Ricketts NPPES

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

MADISON RICKETTS (NPI 1700629862) is an individual medical provider in Rochester, New York, licensed in New York (032375) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with United Memorial Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1700629862
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMADISON RICKETTS
Location Address1415 PORTLAND AVE STE 400Rochester, NY 14621-3022
Mailing Address100 Kings Hwy SRochester, NY 14617-5504
Phone(585) 922-4200
Fax(585) 922-4922
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 17, 2024
Last NPPES UpdateMarch 31, 20265 updates tracked since enumeration
NPPES CertifiedMarch 31, 2026
✔ NPI 1700629862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 032375
1415 PORTLAND AVE STE 400, Rochester, NY 14621
Open in Google Maps ↗

Secondary Practice Locations 3

Location 133 Chandler AveBatavia, NY 14020-1684 · Phone (585) 344-4700 · Fax (585) 344-5454
Location 2222 Alexander St Ste 1100Rochester, NY 14607-4005 · Phone (585) 922-8585 · Fax (585) 922-8555
Location 3293 Upper Falls BlvdRochester, NY 14605-2184 · Phone (585) 922-0260 · Fax (585) 922-0240

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

Madison Ricketts 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 ID2163954918
PECOS Enrollment IDI20241017001648
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.

Hospital Affiliations CMS Care Compare 2

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

United Memorial Medical Center

Acute Care Hospitals · Batavia, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330073
Location127 North StreetBatavia, NY 14020 · Genesee County
Emergency services Birthing friendly

Rochester General Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330125
Location1425 Portland AvenueRochester, NY 14621 · Monroe County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 11

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

EDIE L DERIAN M.D.
Obstetrics & Gynecology (Gynecology)
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4200
MS. CORRINE MARIE WILSON LMSW
Social Worker
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-3653
DANIELLE NANA EKUA ASSIBU-GILMORE CNM
Advanced Practice Midwife
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4400
ALORIBA ZAINAB BRITT CNM
Midwife
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4435
MICHAELA RAHIMI CNM
Advanced Practice Midwife
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4200
LAURA DEPERRIOR
Nurse Practitioner (Family)
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4200
GIANNA MAY GALLUZZO PA-C
Physician Assistant
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4200
DR. JOSEPHINE KATHERINE PORTER MD
Obstetrics & Gynecology
1415 PORTLAND AVE STE 400
ROCHESTER, NY 14621
Monroe County (585) 922-4200

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 Madison Ricketts's NPI number?

The NPI number for Madison Ricketts is 1700629862. It was assigned to this individual provider in the NPPES registry on June 17, 2024.

Where is Madison Ricketts located?

Madison Ricketts practices at 1415 Portland Ave Ste 400, Rochester, NY 14621. The listed phone number is (585) 922-4200.

What is Madison Ricketts's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Madison Ricketts enrolled in Medicare?

Yes. Madison Ricketts 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.

Is Madison Ricketts affiliated with any hospitals?

According to CMS data, Madison Ricketts is affiliated with United Memorial Medical Center and Rochester General Hospital.

When was this NPI record last updated?

The NPPES record for Madison Ricketts was last updated on March 31, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.