Katherine Helen Mader, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58992 Issued in CA

Practice address

100 Pringle Ave Ste 425
Walnut Creek, CA 94596-7385

Phone

(925) 932-3800

Fax

(925) 933-3339

NPI assigned

Nov 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kmader@directaddress.net

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1730416066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PRINGLE AVE",
            "address_2": "STE 425",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945967385",
            "telephone_number": "801-627-0515",
            "fax_number": "801-627-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRINGLE AVE STE 425",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945967385",
            "telephone_number": "925-932-3800",
            "fax_number": "925-933-3339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3860 Jackson Ave",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844031956",
            "country_code": "US",
            "telephone_number": "801-627-0515",
            "fax_number": "801-627-0517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADER",
        "first_name": "KATHERINE",
        "middle_name": "HELEN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58992",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "7494142-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.