Individual provider Active NPI

Madison Wylie Hawkes Gagern

  • Physician Assistant
  • Elkridge, MD
National Provider Identifier
1043852411
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8178 Lark Brown Rd Ste 101
Elkridge, MD 21075-6438
Phone
(410) 646-4800
NPI assigned
Oct 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8178 Lark Brown Rd Ste 101
Elkridge, MD 21075-6438

Mailing address

253 Poe CT
Severna Park, MD 21146-2136
Phone (301) 873-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20220512002837 MD Practitioner - Physician Assistant 6204213226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Spine and Brain Specialists, LLCGroup PAC ID 0547223216, 3 clinicians

Practice addresses (Care Compare)

11055 Little Patuxent Pkwy
Suite L1
Columbia, MD 21044-2897
Phone (410) 646-4800

3407 Wilkens Ave
Suite 250
Baltimore, MD 21229-5216

3407 Wilkens Ave
Suite 250
Baltimore, MD 21229-5222
Phone (410) 646-4800

3449 Wilkens Ave
Suite 100
Baltimore, MD 21229-5216

8178 Lark Brown Rd
Suite 101
Elkridge, MD 21075-6438
Phone (410) 646-4800

Hospital & facility affiliations

  • Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1043852411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 POE CT",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462136",
            "telephone_number": "301-873-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8178 LARK BROWN RD STE 101",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756438",
            "telephone_number": "410-646-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGERN",
        "first_name": "MADISON",
        "middle_name": "WYLIE HAWKES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.