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MR. JACK ENOCH MADSEN IV DPM
NPI 1780943043
Podiatrist in Atlanta, GA

Active since May 08, 2012PECOS EnrolledAccepts Medicare Assignment
5445 MERIDIAN MARK RD, STE. 390, ATLANTA, GA 30342(404) 237-3668(404) 237-9563 Get Directions Write a Review

NPPES record last updated: February 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 10, 2022, Dec 8, 2021 (2 updates tracked since 2021).

About Mr. Jack Enoch Madsen Iv Dpm NPPES

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

MR. JACK ENOCH MADSEN IV DPM (NPI 1780943043) is an individual podiatrist in Atlanta, Georgia, licensed in Georgia (POD001281) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1780943043
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameMR. JACK ENOCH MADSEN IVCredential: DPM
Location Address5445 MERIDIAN MARK RD, STE. 390Atlanta, GA 30342-4763
Mailing Address900 Circle 75 Pkwy Se, Ste. 900Atlanta, GA 30339-3035 · (678) 426-2171 · Fax (404) 446-1957
Phone(404) 237-3668
Fax(404) 237-9563
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMay 8, 2012
Last NPPES UpdateFebruary 10, 20222 updates tracked since enumeration
✔ NPI 1780943043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in GA · POD001281
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
5445 MERIDIAN MARK RD, Atlanta, GA 30342
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jack Enoch Madsen Iv Dpm 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 ID1850607334
PECOS Enrollment IDI20190228001271
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.

Medicare Billing Reassignment

Medicare enrollment records show Jack Madsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
1,866 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30342 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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 5

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

DAREN JAY BECKER DMD
Dentist (General Practice)
5445 MERIDIAN MARK RD, SUITE 275
ATLANTA, GA 30342
Fulton County (404) 252-3188
ASHLEY D THOMAS P.A.-C
Physician Assistant (Medical)
5445 MERIDIAN MARK RD, STE 250
ATLANTA, GA 30342
Fulton County (404) 255-1933
RAJEEV THIRUNAGARI
Pediatrics (Pediatric Endocrinology)
5445 MERIDIAN MARK RD
ATLANTA, GA 30342
Fulton County (404) 785-5437
CALISTA FILLMER
Physician Assistant (Surgical)
5445 MERIDIAN MARK RD
ATLANTA, GA 30342
Fulton County (404) 785-5650
DR. RAVINDER KAUR BRAR MPH, M.D.
Orthopaedic Surgery
5445 MERIDIAN MARK RD, SUITE 250
ATLANTA, GA 30342
Fulton County (404) 255-1933

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 Jack Madsen's NPI number?

The NPI number for Jack Madsen is 1780943043. It was assigned to this individual provider in the NPPES registry on May 8, 2012.

Where is Jack Madsen located?

Jack Madsen practices at 5445 Meridian Mark Rd Ste. 390, Atlanta, GA 30342. The listed phone number is (404) 237-3668.

What is Jack Madsen's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Jack Madsen enrolled in Medicare?

Yes. Jack Madsen 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.

Which organization bills Medicare for Jack Madsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Madsen reassigns Medicare benefits to Southern California Permanente Medical Group (Hemet, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Madsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jack Madsen was last updated on February 10, 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.