MADISON JR. SAMPLE (MD) – Anesthesiology Physician, NPI 1023122215
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,633 ANESTHESIOLOGY in IL
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Provider Addresses for MADISON JR. SAMPLE (MD)
Law Office Of Timothy J Johns, 444, North Northwest Highway, Park Ridge, Cook County, Illinois, 60068, United States
SUITE # 302
PARK RIDGE, IL 600683263
Phone: (847) 696-9015
Fax: (847) 696-9017
Type: Mailing
AMITA Health Resurrection Medical Center, 7435, West Talcott Avenue, Norwood Park, Chicago, Jefferson Township, Cook County, Illinois, 60631, United States
CHICAGO, IL 606313707
Phone: (773) 792-5162
Fax: (773) 594-8589
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $44.
Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($23).
Total Amount
$44
General + Research + Ownership
Payments
2
Total payment records
General Amount
$44
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Hologic Sales and Service, LLC | $23 |
| ATRICURE, INC. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070426000491 | I | Anesthesiology | IL | TBD |
| I20230105000129 | I | Anesthesiology | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 60068)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | IL | 00142 | Anesthesia for lens surgery | 37 | 36 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| Physician Assistant | MI | |
| Internal Medicine | MI | |
| N E U R O L O G Y | MI |
Reviews
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