Kathryn Maddux, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9771131 Issued in ID

Practice address

1618 S Millenium Way Ste 100
Meridian, ID 83642-6457

Phone

(208) 884-3376

Fax

(208) 884-0858

NPI assigned

Jan 13, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, ID2 enrollments

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 2

Specialty

Physician Assistant

Education

Midwestern University College of Dental Medicine, Downers Grove, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ada West Dermatology, P.C.Group PAC ID 1153341532, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ada West Dermatology, PC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1518973338
  Medicare reassignment Care Compare group
• Tareen Dermatology, P.a.

  • Dermatology Physician
  • Roseville, MN
  • NPI 1063782621

  WI

  Medicare reassignment

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

• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1194430157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUX",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "9771131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmaddux@adawest.emadirect.md",
            "affiliation": "N",
            "address_1": "1618 S Millenium Way Ste 100",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836426457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katrina Larene Mace
• Rebecca Mace
• Julie Macgregor, PA-C, LE
• Mack B. Stephenson, PH.D., CHTD
• Mark Macumber, MD
• Joseph Maggio, DPT
• Claire Magnolo, PA-C
• Jonathan Eric Main, DC
• Mireya Frances Mains, LMSW
• Maitri Community Services

• Medical Physician Assistant in Meridian, ID
• Providers in Meridian, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.