Individual provider Active NPI

Katie Lynn Madlen, PA-C

  • Physician Assistant
  • Massapequa, NY
National Provider Identifier
1457977969
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025075 Issued in NY
Practice address
5550 Merrick Rd
Massapequa, NY 11758-6238
Phone
(631) 673-3233
NPI assigned
Jun 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 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 025075 NY Primary

Addresses

Primary practice location

5550 Merrick Rd
Massapequa, NY 11758-6238

Mailing address

5550 Merrick Rd
Massapequa, NY 11758-6238
Phone (631) 673-3233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210128002611 NY Practitioner - Physician Assistant 8022422278 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
Telehealth
Offers telehealth services
Group practices
Priyadarshan Bajpayi MD PCGroup PAC ID 6608118179, 13 clinicians

Practice addresses (Care Compare)

5550 Merrick Rd
Massapequa, NY 11758-6238
Phone (631) 673-3233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1457977969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586238",
            "telephone_number": "631-673-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586238",
            "telephone_number": "631-673-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADLEN",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-20",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.