Madeline Ustanik

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

13235 Robert Walker Dr
Davidson, NC 28036-6005

Phone

(607) 438-0748

NPI assigned

May 18, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iredell Physician Network LLC

  • General Practice Physician
  • Statesville, NC
  • NPI 1811381593
  Medicare reassignment Care Compare group
• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment
• Iredell Physician Network LLC

  • Family Medicine Physician
  • Statesville, NC
  • NPI 1326862848
  NPD
• Iredell Physician Network LLC

  • Otolaryngology Physician
  • Statesville, NC
  • NPI 1447063920
  NPD
• Iredell Physician Network LLC

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1780822288
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1003665290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 ROBERT WALKER DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280366005",
            "telephone_number": "607-438-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 ROBERT WALKER DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280366005",
            "telephone_number": "607-438-0748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 Bluefield Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179626",
            "country_code": "US",
            "telephone_number": "704-360-6460",
            "fax_number": "980-444-2631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286254302",
            "country_code": "US",
            "telephone_number": "704-380-6900",
            "fax_number": "704-380-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USTANIK",
        "first_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Triplett, SLP
• Nicole Twele, PHARM.D.
• Marianne Parsons Umphlett
• University Eye Associates, OD PA
• Upward Therapy
• McKenna Vaudrin
• Holly Vermillion, NP
• Ashlan Vincent
• Gerry Lee Waddle Jr.
• Elizabeth Ashley Wallace, PHARMD

• Physician Assistant in Davidson, NC
• Providers in Davidson, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.