Mr Jack Enoch Madsen Iv, DPM - Medicare Podiatrist in Atlanta, GA

Mr Jack Enoch Madsen Iv, DPM is a medicare enrolled "Podiatrist" provider in Atlanta, Georgia. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is 5445 Meridian Mark Rd, Ste. 390, Atlanta, Georgia. You can reach out to his office (for appointments etc.) via phone at (404) 237-3668.

Mr Jack Enoch Madsen Iv is licensed to practice in Georgia (license number POD001281) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780943043.

Contact Information

Mr Jack Enoch Madsen Iv, DPM
5445 Meridian Mark Rd, Ste. 390,
Atlanta, GA 30342-4763
(404) 237-3668
(404) 237-9563



Healthcare Provider's Profile

Full NameMr Jack Enoch Madsen Iv
GenderMale
SpecialityPodiatry
Experience12 Years
Location5445 Meridian Mark Rd, Atlanta, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Jack Enoch Madsen Iv graduated from medical school in 2012
  NPI Data:
  • NPI Number: 1780943043
  • Provider Enumeration Date: 05/08/2012
  • Last Update Date: 02/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1850607334
  • Enrollment ID: I20190228001271

Medical Identifiers

Medical identifiers for Mr Jack Enoch Madsen Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780943043NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213E00000XPodiatrist POD001281 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kaiser Foundation Hospital Fontana/ontarioFontana, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southern California Permanente Medical Group60027291757951

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jack Enoch Madsen Iv allows following entities to bill medicare on his behalf.
Provider NameSouthern California Permanente Medical Group
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jack Enoch Madsen Iv is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Jack Enoch Madsen Iv, DPM
900 Circle 75 Pkwy Se, Ste. 900,
Atlanta, GA 30339-3035

Ph: (678) 426-2171
Mr Jack Enoch Madsen Iv, DPM
5445 Meridian Mark Rd, Ste. 390,
Atlanta, GA 30342-4763

Ph: (404) 237-3668

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