Individual provider Active NPI

Madeline Mary Beisel

  • Physician Assistant
  • New York, NY
National Provider Identifier
1508498965
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026312 Issued in NJ
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(443) 878-4362
NPI assigned
Feb 4, 2020
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 026312 NJ Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

52 Llewellyn Rd
Montclair, NJ 07042-2532
Phone (443) 878-4362

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmatotek18@su.edu Shenandoah University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260406002111 NJ Practitioner - Physician Assistant 7810399425 Reassigns benefits to 2 organizations

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
Senior Healthcare Outreach ProgramGroup PAC ID 5890893713, 12 clinicians
Salerno Medical Associates, LLCGroup PAC ID 3678676434, 38 clinicians

Practice addresses (Care Compare)

613 Park Ave
1St
East Orange, NJ 07017-1905
Phone (973) 672-8573

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026312NJMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: mam9894@direct.nyp.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1508498965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 LLEWELLYN RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422532",
            "telephone_number": "443-878-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "443-878-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEISEL",
        "first_name": "MADELINE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "026312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmatotek18@su.edu",
            "affiliation": "Y",
            "affiliationName": "Shenandoah University",
            "address_1": "1460 University Dr",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226015100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.