KATHRYN MADDUX (PA-C) – Physician Assistant, NPI 1194430157

KATHRYN MADDUX (PA-C) is a healthcare provider. based in Roseville, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9771131 (ID). The NPI Number for KATHRYN MADDUX (PA-C) is 1194430157

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN MADDUX (PA-C)
NPI
1194430157
Phone
Not provided
Address
2720 FAIRVIEW AVE N STE 200
Enumeration Date
13 January 2023
Last Update Date
4 June 2025

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE, DOWNERS GROVE
Secondary Phone
2088843376
Graduation Year
2022 (4 years ago)
PAC ID
4486001013
Group Practice PAC ID
1153341532
Professional Enrollment ID
I20241209002959
Address ID
ID836426457ME1618XWAYX401

Contacts

Secure Messaging
kmaddux@adawest.emadirect.md
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

1,534 PHYSICIAN ASSISTANT in ID

Provider Addresses for KATHRYN MADDUX (PA-C)

  • 2720 FAIRVIEW AVE N STE 200

    ROSEVILLE, MN 551131306

    Phone:

    Type: Mailing

  • 1618 S MILLENIUM WAY STE 100

    MERIDIAN, ID 836426457

    Phone: (208) 884-3376

    Fax: (208) 884-0858

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $323.

Total Amount is formed as General ($323) + Research ($0) + Ownership ($0) = $323.

Last reported payment date: 2024-06-13 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($192).

Total Amount

$323

General + Research + Ownership

Payments

4

Total payment records

General Amount

$323

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-12-09

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
I20240722002729IPhysician AssistantWITBD
I20241209002959IPhysician AssistantIDTBD

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 55113)

Loading plans...

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: 1153341532View full group profile
NameSpecialtyState
Physician AssistantID
Nurse PractitionerID
D E R M A T O L O G YAL
Physician AssistantID
D E R M A T O L O G YID
Physician AssistantID
Physician AssistantID
Physician AssistantID
D E R M A T O L O G YID
Physician AssistantID

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I cross-check KATHRYN MADDUX (PA-C) using NPI 1194430157?
NPI 1194430157 belongs to KATHRYN MADDUX (PA-C); compare other details if you need extra assurance.
Active or inactive — what applies to KATHRYN MADDUX (PA-C)?
You should see KATHRYN MADDUX (PA-C) as active in CMS-hosted NPPES data.
What kind of doctor is KATHRYN MADDUX (PA-C)?
KATHRYN MADDUX (PA-C) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is KATHRYN MADDUX (PA-C) associated with Roseville?
Public fields place KATHRYN MADDUX (PA-C) around Roseville, Minnesota. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for KATHRYN MADDUX (PA-C) is noted as January 13, 2023 where the registry provides it.

Similar Providers

BRENT D. PLACKNER (PA-C)

Physician Assistant
140, 6041, Duet Way, Roseville, Placer County, California, United States
NPI: 1487647996
1835 County Road C W Ste 150
NPI: 1043293673

ERIN R MAGUIRE (PA-C)

Physician Assistant
6500 EXCELSIOR BLVD
NPI: 1427029131

MR. ERIC SAGE SALMAN (P.A.C)

Physician Assistant
1950, Curve Crest Boulevard West, Stillwater, Washington County, Minnesota, 55082, United States
NPI: 1366488587

STEPHANIE P ELKO (MPAS, PA-C)

Medical Physician Assistant
Metro OBGYN
NPI: 1508893561

HEATHER A ZAUN (PAC)

Physician Assistant
710 COMMERCE DR STE 200
NPI: 1780699074

MR. RANDAL NELSON (P.A.)

Physician Assistant
West 81st Street, Bloomington, Hennepin County, Minnesota, 55420, United States
NPI: 1558474197

SHELLY ANN WINSLOW (PA-C)

Physician Assistant
7400, France Avenue South, Parklawn, Edina, Hennepin County, Minnesota, 55435, United States
NPI: 1689776544

JENNIFER A SCHMITZ (PA)

Physician Assistant
Starbucks, 1515, County Road B West, Roseville, Ramsey County, Minnesota, 55113, United States
NPI: 1679671218