MRS. MARILYN PELLETIER MADAJCZYK FNP-BC
NPI 1578730875
Nurse Practitioner - Family in Ray, MI
About Mrs. Marilyn Pelletier Madajczyk Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. MARILYN PELLETIER MADAJCZYK FNP-BC (NPI 1578730875) is an individual family provider in Ray, Michigan, licensed in Michigan (11200003) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Marilyn Pelletier Madajczyk Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Marilyn Madajczyk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Eastpointe, MI 48021
- Reassigned Medicare billing, Michigan enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48096 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Marilyn Madajczyk's NPI number?
The NPI number for Marilyn Madajczyk is 1578730875. It was assigned to this individual provider in the NPPES registry on May 15, 2008. The provider is also known as Mrs. Marilyn Adams Fnp-Bc.
Where is Marilyn Madajczyk located?
Marilyn Madajczyk practices at 21380 31 Mile Rd, Ray, MI 48096. The listed phone number is (989) 254-0576.
What is Marilyn Madajczyk's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Marilyn Madajczyk enrolled in Medicare?
Yes. Marilyn Madajczyk is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Marilyn Madajczyk's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marilyn Madajczyk reassigns Medicare benefits to Eastpointe Urgent Care Walk In Clinic P.C. (Eastpointe, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marilyn Madajczyk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Marilyn Madajczyk was last updated on December 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Marilyn Pelletier Madajczyk, FNP-BC · NPI 1578730875
Family physician in Ray, Michigan. Individual provider, active in the CMS NPPES registry since May 15, 2008.
## Identity
- **NPI:** 1578730875 (Entity type: Individual)
- **Enumerated:** May 15, 2008
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 11200003 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 21380 31 MILE RD, Ray, MI 48096-1319
- **Phone:** (989) 254-0576
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Eastpointe Urgent Care Walk In Clinic P.C. (NPI 1982125126, Eastpointe, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 11, 2020
- **Other identifiers:** Medicaid 11200003 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1578730875) · Data from the CMS NPPES public registry.