Individual provider Active NPI

Daniel Joseph Madock, D.C.

  • Independent Medical Examiner Chiropractor
  • Temple Terrace, FL
National Provider Identifier
1053518845
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X
License
CH00003299 Issued in FL
Practice address
11404 N 56TH St
Suite 101
Temple Terrace, FL 33617-2237
Phone
(813) 935-1664
Fax
(813) 985-8797
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Chiropractor 111NI0013X CH00003299 FL Primary

Addresses

Primary practice location

11404 N 56TH St
Suite 101
Temple Terrace, FL 33617-2237

Mailing address

11404 N 56TH St
Suite 101
Temple Terrace, FL 33617-2237
Phone (813) 935-1664

Other identifiers 1

IdentifierTypeStateIssuer
380679100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080428000401 FL Practitioner - Chiropractic 5698853984 Reassigns benefits to 1 organization
Practice locations: Tampa, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7827 N Armenia Ave
Tampa, FL 33604-3849
Phone (813) 310-0840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00003299FLMDIndependent Medical Examiner Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Center CurrentSince Jul 23, 2018 Accepting new patients
Jessica J Wilson Chan D O PA PastSince Nov 3, 2019 Accepting new patients

Locations

14522 University Point Pl
Tampa, FL 33613
Phone (813) 978-0020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1053518845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 N 56TH ST",
            "address_2": "SUITE 101",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172237",
            "telephone_number": "813-935-1664",
            "fax_number": "813-985-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11404 N 56TH ST",
            "address_2": "SUITE 101",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172237",
            "telephone_number": "813-935-1664",
            "fax_number": "813-985-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADOCK",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "FL",
            "license": "CH00003299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380679100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.