Individual provider Active NPI

Kevin Bradley Cederberg, MD

  • Diagnostic Radiology Physician
  • Dallas, TX
National Provider Identifier
1104020296
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M6070 Issued in TX
Practice address
5323 Harry Hines Blvd
Department of Radiology
Dallas, TX 75390-8896
Phone
(214) 648-8004
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X M6070 TX
Diagnostic Radiology Physician 2085R0202X M6070 TX Primary
Pediatric Radiology Physician 2085P0229X M6070 TX

Addresses

Primary practice location

5323 Harry Hines Blvd
Department of Radiology
Dallas, TX 75390-8896

Mailing address

5323 Harry Hines Blvd
Department of Radiology
Dallas, TX 75390-8896
Phone (214) 648-8004

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0018147OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000386 TX Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 4981737780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (469) 323-8870

2350 N Stemmons Frwy
Dallas, TX 75207-2700
Phone (844) 424-4537

2350 N Stemmons Fwy
Dallas, TX 75207-2700

2350N Stemmons Fwy 4300
Dallas, TX 75207-2700
Phone (214) 645-0624

Hospital & facility affiliations

  • Childrens Medical Ctr of Dallas Hospital, Dallas, TX, CCN 453302

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6070TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Pediatric Imaging Associates LLC CurrentSince Sep 10, 2015 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2010 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients

Locations

10057 County Road 472
Anna, TX 75409

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1104020296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908896",
            "telephone_number": "214-648-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908896",
            "telephone_number": "214-648-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDERBERG",
        "first_name": "KEVIN",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "M6070",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "M6070",
            "primary": true
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "M6070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0018147",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.