Individual provider Active NPI

Madeline R Mulder

  • Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1053185694
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95027190 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 345
Pasadena, CA 91105-2677
Phone
(424) 314-0203
Fax
(424) 314-0206
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95027190 CA
Nurse Practitioner 363L00000X 95027190 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 345
Pasadena, CA 91105-2677

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

435 Arden Ave Ste 460
Glendale, CA 91203-1139
Phone (888) 209-8874

Other practice location 2

3109 Madera Ave
Los Angeles, CA 90039-2324
Phone (805) 459-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240202001840 CA Practitioner - Nurse Practitioner 9537512819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

625 S Fair Oaks Ave
Suite 345
Pasadena, CA 91105-2677
Phone (424) 314-0203

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Sep 30, 2024 Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1513 S Grand Ave
Ste 360
Los Angeles, CA 90015
Phone (213) 246-2422

625 S Fair Oaks Ave
Ste 345
Pasadena, CA 91105
Phone (424) 314-0203

925 S Fair Oaks Ave Ste 345
Ste 345
Pasadena, CA 91105

399 E Highland Ave
Ste 501
Sn Bernrdno, CA 92404
Phone (909) 982-4252

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: mmulder506629@direct.cshs.org

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 3

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": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1053185694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 345",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052677",
            "telephone_number": "424-314-0203",
            "fax_number": "424-314-0206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Arden Ave Ste 460",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912031139",
            "country_code": "US",
            "telephone_number": "888-209-8874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3109 Madera Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900392324",
            "country_code": "US",
            "telephone_number": "805-459-1863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "MADELINE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95027190",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95027190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.