MADALYN MARIE NYGREN (MD) – Student in an Organized Health Care Education/Training Program, NPI 1336725779

MADALYN MARIE NYGREN (MD) is a healthcare provider. based in Orange park, Florida. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. MD20047 (RI). The NPI Number for MADALYN MARIE NYGREN (MD) is 1336725779

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MADALYN MARIE NYGREN (MD)
NPI
1336725779
Phone
(904) 639-2000
Address
2001 KINGSLEY AVE
Enumeration Date
23 March 2021
Last Update Date
1 December 2025

Doctor Profile

Medical School Name
OAKLAND UNIV, WILLIAM BEAUMONT SCHOOL OF MEDICINE
Secondary Phone
4014562000
Graduation Year
2021 (5 years ago)
PAC ID
0648718932
Group Practice PAC ID
9739487562
Professional Enrollment ID
I20250828004204
Address ID
RI029084728PR825XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:5State licenses:2Digital endpointsOther names

3,232 EMERGENCY MEDICINE in FL

Provider Addresses for MADALYN MARIE NYGREN (MD)

  • 2001 KINGSLEY AVE

    ORANGE PARK, FL 320735148

    Phone: (904) 639-2000

    Fax: (904) 639-2015

    Type: Mailing

  • 825 Chalkstone Ave

    Providence, RI 029084728

    Phone: (401) 456-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240819000132IEmergency MedicineMATBD
I20250828004204IEmergency MedicineRITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32073)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739487562View full group profile
NameSpecialtyState
Emergency MedicineRI
Nurse PractitionerRI
Emergency MedicineRI
Emergency MedicineNY
-RI
Emergency MedicineRI
Emergency MedicineOH
Emergency MedicineRI
Emergency MedicineRI
Emergency MedicineRI

Reviews

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Frequently asked questions

What identifier follows MADALYN MARIE NYGREN (MD) across health systems?
The NPI 1336725779 uniquely identifies MADALYN MARIE NYGREN (MD) in U.S. healthcare data.
Is MADALYN MARIE NYGREN (MD)'s NPI status active today?
Active status means MADALYN MARIE NYGREN (MD)'s NPI record is not deactivated in the public file.
What services align with MADALYN MARIE NYGREN (MD)'s listing?
MADALYN MARIE NYGREN (MD)'s public classification highlights Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
Is MADALYN MARIE NYGREN (MD) tied to Orange Park, Florida?
If you are local to Orange Park, Florida, MADALYN MARIE NYGREN (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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