Madelyn Wallace, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4015 Chichester Ave
Upper Chichester, PA 19061-3138

Phone

(610) 494-4422

NPI assigned

Aug 19, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Joel Samuel Goldberg, DO

  • Family Medicine Physician
  • Upper Chichester, PA
  • NPI 1699714402
  Medicare reassignment
• Joel S. Goldberg

  • Family Medicine Physician
  • Boothwyn, PA
  • NPI 1972704971
  NPD (past)

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760227200000",
    "number": "1952288219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 CHICHESTER AVE",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613138",
            "telephone_number": "610-494-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 CHICHESTER AVE",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613138",
            "telephone_number": "610-494-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MADELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shairin Syed, OD
• The Boothwyn Fire Company No 1
• Amanda Noelle Tonkinson, MA
• Eileen Marie Tumolo, RPH,CIP
• Walgreen Co (Walgreens #11077)
• Ayden Wardius
• Ware Medical Associates
• Brooke Waugh
• Andrew C Wee, PHARMD
• Wellness Family Pharmacy

• Physician Assistant in Upper Chichester, PA
• Providers in Upper Chichester, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; 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.