Individual provider Active NPI

Madison Ann Minnick, PA-C

  • Surgical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1649744178
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA060311 Issued in PA
Practice address
3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206
Phone
(215) 662-3487
Fax
(215) 349-5534
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00603200 NJ
Surgical Physician Assistant 363AS0400X MA060311 PA Primary

Addresses

Primary practice location

3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206
Phone (215) 662-3487

Other practice location 1

1600 Haddon Ave
Camden, NJ 08103-3101
Phone (609) 832-5060

Other names 1

  • Madison Ann Vitelli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20190130000696 PA Practitioner - Physician Assistant 2466799382 Reassigns benefits to 3 organizations
I20220331001166 NJ Practitioner - Physician Assistant 2466799382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1671 Crooked Oak Dr
Lancaster, PA 17601-4269
Phone (717) 569-5331

554 N Duke St
LGHP Penn Med Plastic and Cosmetic Surgery
Lancaster, PA 17602-2250
Phone (717) 291-5863

555 N Duke St
Lancaster, PA 17602-2250

555 N Duke St 1St Floor
LGHP Penn Medicine Behavioral Health
Lancaster, PA 17602-2250
Phone (717) 560-3782

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00603200NJMDSurgical Physician Assistant
MA060311PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jan 2, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 28, 2019 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 19, 2024 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 19, 2024 Accepting new patients
Einstein Practice Plan Inc CurrentSince Nov 15, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Nov 15, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 28, 2019 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jan 2, 2022 Accepting new patients
Lancaster General Medical Group Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1671 Crooked Oak Dr
Lancaster, PA 17601
Phone (717) 569-5331

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863

1701 Cornwall Rd
Lebanon, PA 17042
Phone (717) 675-1750

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

3400 Spruce St
Fl 3
Philadelphia, PA 19104

9880 Bustleton Ave
Ste 205
Philadelphia, PA 19115
Phone (215) 676-2222

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 13

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.

View all 13

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1649744178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "3 SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3487",
            "fax_number": "215-349-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "3 SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3487",
            "fax_number": "215-349-5534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "609-832-5060",
            "fax_number": "609-261-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "MADISON",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00603200",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA060311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "VITELLI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.