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Madison Lynn Jurcenko

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821

PECOS Enrollment

This provider is enrolled in PECOS as MADISON JURCENKO.

Based on the most recent information from CMS, provider Madison Lynn Jurcenko is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1629685326
Provider Type
Individual
Full Name
Jurcenko, Madison Lynn
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/26/2020
Last Updated
6/23/2023

Contact Information

Practice Location

11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821

(980) 308-0169

Unlisted Fax

Mailing Location

PO Box 601843, Charlotte, NC 28260-1843

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-12531 North Carolina
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 025682 New York

Madison Lynn Jurcenko

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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