MADISON PETTY (PA) – Physician Assistant, NPI 1205545761

MADISON PETTY (PA) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA2768 (NV). The NPI Number for MADISON PETTY (PA) is 1205545761

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MADISON PETTY (PA)
NPI
1205545761
Phone
(702) 385-4342
Address
7150 W SUNSET RD STE 200
Enumeration Date
22 November 2022
Last Update Date
1 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
4587024252
Group Practice PAC ID
5294713335
Professional Enrollment ID
I20230713002526
Address ID
NV891131982LA7150XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for MADISON PETTY (PA)

  • 7150 W SUNSET RD STE 200

    LAS VEGAS, NV 891131982

    Phone: (702) 385-4342

    Fax: (702) 385-4346

    Type: Mailing

  • 7150 W SUNSET RD STE 201A

    LAS VEGAS, NV 891131982

    Phone: (702) 385-4342

    Fax: (702) 385-4346

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $400.

Total Amount is formed as General ($400) + Research ($0) + Ownership ($0) = $400.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($86).

Total Amount

$400

General + Research + Ownership

Payments

19

Total payment records

General Amount

$400

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-07-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230713002526IPhysician AssistantNVTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1716$0
View full utilization report →

Insurance plans in this area (ZIP 89113)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294713335View full group profile
NameSpecialtyState
U R O L O G YNV
Physician AssistantNV
Physician AssistantCA
U R O L O G YNV
-NV
U R O L O G YNV
-NV
U R O L O G YNV
U R O L O G YFL
Physician AssistantNV

Reviews

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Frequently asked questions

What number should I use to identify MADISON PETTY (PA) for billing?
Administrative and clinical systems typically use NPI 1205545761 for MADISON PETTY (PA).
Quick check: is MADISON PETTY (PA) active?
Public NPPES data shows MADISON PETTY (PA) with an active NPI status right now.
What does the directory say MADISON PETTY (PA) does?
Insurance directories may phrase it differently, but here MADISON PETTY (PA) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MADISON PETTY (PA)?
MADISON PETTY (PA) is associated with Las Vegas, Nevada in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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