MADALYN ROSE BACZKOWSKI (DNP, AGPCNP-BC) – Nurse Practitioner, NPI 1114603560
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
8,161 NURSE PRACTITIONER in MI
Provider Addresses for MADALYN ROSE BACZKOWSKI (DNP, AGPCNP-BC)
11883 Trailwood Rd
Plymouth, MI 481703730
Phone: (248) 928-4851
Type: Location
26901 BEAUMONT BLVD
SOUTHFIELD, MI 480333849
Phone:
Type: Mailing
3601 W 13 MILE RD
ROYAL OAK, MI 480736712
Phone: (248) 551-4400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $271.
Total Amount is formed as General ($271) + Research ($0) + Ownership ($0) = $271.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($186).
Total Amount
$271
General + Research + Ownership
Payments
8
Total payment records
General Amount
$271
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | $186 |
| AstraZeneca Pharmaceuticals LP | $85 |
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: 2023-10-02
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231002002278 | I | Nurse Practitioner | MI | TBD |
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.
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 48170)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| Physician Assistant | MI |
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