Kathryn Susan Maceyko, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP015487 Issued in PA

Practice address

150 Monument Rd Ste 500
Bala Cynwyd, PA 19004-1701

Phone

(855) 478-8208

NPI assigned

Nov 13, 2015

Last updated

Jan 29, 2026By the provider in NPPES

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

Enrolled in PA, NC, SC3 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 3

Specialty

Nurse Practitioner

Education

Jefferson Medical College of Thomas Jefferson University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Patina Medical Group, PCGroup PAC ID 2567828460, 5 clinicians

Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathryn.maceyko.p1@direct.tandigmhealth.nextgenshare.com

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.

• Patina Medical Group, PC

  • Primary Care Clinic/Center
  • Bala Cynwyd, PA
  • NPI 1801568910
  Medicare reassignment Care Compare group NPD
• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764

  PA

  Medicare reassignment Care Compare group NPD
• Ennoble HC NJ II PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1871475806

  PA

  Medicare reassignment NPD
• Ennoble HC NJ III PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1043192099

  PA

  Medicare reassignment NPD
• Patina Medical Group, PC

  • Primary Care Clinic/Center
  • Charlotte, NC
  • NPI 1467147710

  SC

  Medicare reassignment NPD

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1760856736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 500",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041701",
            "telephone_number": "855-478-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 500",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041701",
            "telephone_number": "855-478-8208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Greenwood Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "190462649",
            "country_code": "US",
            "telephone_number": "973-241-1356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Chestnut St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191062608",
            "country_code": "US",
            "telephone_number": "973-241-1356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACEYKO",
        "first_name": "KATHRYN",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015487",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN662358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenzie Lynch
• Richard B. Lynn, M.D.
• Ruthi Lynn, MFT
• Lyricly Behavioral Wellness (LyricLy Behavioral Health)
• Margaret Ellen Maas, M.D.
• Amy Macintyre, MD
• Sandra M Mack, MSW,CSW
• Frank Macri, DPM
• Farideh M Madani, DMD
• Mansoor Madani, DMD

• Family Nurse Practitioner in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.