PAUL W MADONIA MD
NPI 1164496188
Family Medicine in Flemington, NJ
NPI Status: Active since February 15, 2006
Contact Information
9100 WESCOTT DR
SUITE 103
FLEMINGTON, NJ
ZIP 08822
Phone: (908) 237-6910
Fax: (908) 237-6919
- Individual
- Male
- Family Medicine
- PECOS Enrolled
About PAUL MADONIA
This page provides the complete NPI Profile along with additional information for Paul Madonia, a primary care provider established in Flemington, New Jersey with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1164496188 assigned on February 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 25MA02650200 (NJ). The provider is registered as an individual and his NPI record was last updated 13 years ago.
- NPI
- 1164496188
- Provider Name
- PAUL W MADONIA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822
- Location Phone
- (908) 237-6910
- Location Fax
- (908) 237-6919
- Mailing Address
- 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822
- Mailing Phone
- (908) 237-6910
- Mailing Fax
- (908) 237-6919
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-15-2006
- Last Update Date
- 06-27-2012
- Code Navigator
A primary care provider (PCP) like Paul Madonia sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA02650200
- License State
- NJ
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0590304 | MEDICAID (05) | NJ | |
| C53433 | MEDICARE UPIN (02) | NJ | |
| MA130021 | MEDICARE ID-TYPE UNSPECIFIED (04) | NJ |
Medicare Participation & PECOS Enrollment Status
Paul Madonia is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 08822 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $98.09
- Minimum New Patient Price $63.84
- Maximum New Patient Price $190.92
- Average New Patient Copayment $24.52
- Minimum New Patient Copayment $15.96
- Maximum New Patient Copayment $47.73
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $111.57
- Minimum Established Patient Price $20.97
- Maximum Established Patient Price $155.92
- Average Established Patient Copayment $27.89
- Minimum Established Patient Copayment $5.24
- Maximum Established Patient Copayment $38.98
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 6 | 4 | 4 | 9 | 6 | 1 | 8 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 12 | 4 | 8 | 9 | 12 | 1 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 2 + 4 + 8 + 9 + 1 + 2 + 1 + 1 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1164496188 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235103318 | DARIO A LECUSAY JR. MD Individual | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1508926650 | MRS. BEVERLEY J MANGANELLI R.D., CDE Individual | Dietitian, Registered | 9100 WESCOTT DR SUITE 102 FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1508928904 | HUNTERDON MEDICAL CENTER Organization | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1629131008 | HUNTERDON MEDICAL CENTER Organization | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 9100 WESCOTT DR FLEMINGTON, NJ 08822 (908) 237-6990 |
| 1760546170 | MISS MICHELLE DOREEN WRIGHT M.S., R.D., CDE Individual | Dietitian, Registered | 9100 WESCOTT DR SUITE 102 FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1528117678 | KATHY ROBERTS MS RD CDE Individual | Dietitian, Registered | 9100 WESCOTT DR SUITE 102 FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1316096381 | MS. DEBORAH SHANTI KENGETER BS RD CDE Individual | Dietitian, Registered | 9100 WESCOTT DR FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1154476356 | KATHLEEN M LOMBARDI R.D., CDE Individual | Dietitian, Registered | 9100 WESCOTT DR FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1548380900 | HUNTERDON MEDICAL CENTER Organization | General Acute Care Hospital | 9100 WESCOTT DR SUITE 102 FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1841455466 | MRS. PAULA S HAZARD R.D. Individual | Dietitian, Registered | 9100 WESCOTT DR SUITE 102 FLEMINGTON, NJ 08822 (908) 237-6920 |
| 1033104815 | MARTHA ANDERSON PA Individual | Physician Assistant | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6919 |
| 1396038113 | DR. GENEA MUKHERJI M.D. Individual | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1326419722 | HUNTERDON SPECIALTY CARE PC Organization | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 9100 WESCOTT DR SUITE 101 FLEMINGTON, NJ 08822 (908) 237-6990 |
| 1609971118 | SMITA PATIL RANDHAWA MD, MPH Individual | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1982869335 | DR. TIMOTHY MUI MD Individual | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1770557837 | MARC I SANDBERG MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 9100 WESCOTT DR SUITE 101 FLEMINGTON, NJ 08822 (908) 237-6900 |
| 1881890416 | DR. SAIMA KHAN MD Individual | Internal Medicine | 9100 WESCOTT DR SUITE 101 FLEMINGTON, NJ 08822 (908) 237-6990 |
| 1508936428 | DR. STACEY R. BACHRACH MD Individual | General Practice | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
| 1235244674 | DR. ROBERT M LIND MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 9100 WESCOTT DR SUITE 101 FLEMINGTON, NJ 08822 (908) 237-6990 |
| 1902277361 | HUNTERDON PRIMARY CARE, PC Organization | Family Medicine | 9100 WESCOTT DR SUITE 103 FLEMINGTON, NJ 08822 (908) 237-6910 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164496188, enumerated in the NPI registry as an "individual" on February 15, 2006
The provider is located at 9100 Wescott Dr Suite 103 Flemington, Nj 08822 and the phone number is (908) 237-6910
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $98.09 with an average copayment of $24.52 for new patient appointments. Established patients should expect a typical charge of $111.57 and an average copayment of 27.89. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on February 15, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.