Individual provider Active NPI

Lindsay Maudrie, P.A.

  • Medical Physician Assistant
  • Wyandotte, MI
National Provider Identifier
1730413113
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601005604 Issued in MI
Practice address
995 Ford Ave
Wyandotte, MI 48192-3861
Phone
(734) 284-3100
Fax
(734) 284-8212
NPI assigned
Oct 1, 2009
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005604 MI Primary

Addresses

Primary practice location

995 Ford Ave
Wyandotte, MI 48192-3861

Mailing address

995 Ford Ave
Wyandotte, MI 48192-3861
Phone (434) 284-3100

Other names 1

  • Miss Lindsay Feldt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110202000469 MI Practitioner - Physician Assistant 4688854029 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Medical Group South PC PastSince Apr 19, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCJGBD
  • Direct secure messaging: lindsay.maudrie@smc995.eclinicaldirectplus.com
  • Direct secure messaging: lmaudrie59536@direct.hfhs.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.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1730413113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923861",
            "telephone_number": "434-284-3100",
            "fax_number": "734-284-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923861",
            "telephone_number": "734-284-3100",
            "fax_number": "734-284-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUDRIE",
        "first_name": "LINDSAY",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "FELDT",
            "prefix": "MISS",
            "credential": "P,A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.