NPIMap

Individual provider Active NPI

Madeleine Sertic

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1124651658
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
286998 Issued in MA
Practice address
Division of Abdominal Imaging, Department of Radiology,
55 Fruit Street, White 270
Boston, MA 02114
Phone
(617) 643-2009
Fax
(617) 726-4891
NPI assigned
Feb 12, 2020
Reactivated
Dec 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 286998 MA Primary

Addresses

Primary practice location

Division of Abdominal Imaging, Department of Radiology,
55 Fruit Street, White 270
Boston, MA 02114

Mailing address

Division of Abdominal Imaging, Department of Radiology,
55 Fruit Street, White 270
Boston, MA 02114
Phone (617) 643-2009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809000395 MA Practitioner - Diagnostic Radiology 0840694287 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

335 Revolution Dr
Somerville, MA 02145-1553
Phone (857) 282-7750

4 Centennial Dr
Peabody, MA 01960-7935
Phone (978) 532-6635

440 Foley St
Somerville, MA 02145-1213
Phone (857) 282-0777

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

57 Prospect St
Nantucket, MA 02554-2799
Phone (508) 825-8100

80 Everett Ave
Chelsea, MA 02150-2339
Phone (617) 887-3500

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Feb 12, 2026 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
#270
Boston, MA 02114
Phone (617) 643-2009

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

Interoperability endpoints

  • Direct secure messaging: sertic.madeleine.mgh@direct.partners.masshiway.net

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 6

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1124651658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DIVISION OF ABDOMINAL IMAGING, DEPARTMENT OF RADIOLOGY,",
            "address_2": "55 FRUIT STREET, WHITE 270",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-643-2009",
            "fax_number": "617-726-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DIVISION OF ABDOMINAL IMAGING, DEPARTMENT OF RADIOLOGY,",
            "address_2": "55 FRUIT STREET, WHITE 270",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-643-2009",
            "fax_number": "617-726-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERTIC",
        "first_name": "MADELEINE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "deactivation_date": "2020-12-08",
        "reactivation_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "286998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.