Maddison Lee Walczak, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HID-1010 Issued in MN

Practice address

3021 Harbor LN N Ste 212
Plymouth, MN 55447-5120

Phone

(763) 367-6012

Fax

(763) 308-3361

NPI assigned

Nov 2, 2026

Last updated

Nov 2, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1295634806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 HOWARD AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 HARBOR LN N STE 212",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475120",
            "telephone_number": "763-367-6012",
            "fax_number": "763-308-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCZAK",
        "first_name": "MADDISON",
        "middle_name": "LEE",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MN",
            "license": "HID-1010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing Instrument Specialist in Plymouth, MN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.