Individual provider Active NPI

Thomas Philip Madaelil, MD

  • Neuroradiology Physician
  • Saint Louis, MO
National Provider Identifier
1144513177
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
S0502 Issued in TX
Practice address
510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone
(314) 362-5460
NPI assigned
May 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT199111 PA
Diagnostic Radiology Physician 2085R0202X 2016009664 MO
Neuroradiology Physician 2085N0700X S0502 TX Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016

Mailing address

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone (314) 362-5460

Other practice location 1

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-6000

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
I20190625003552 TX Practitioner - Diagnostic Radiology 7719116375 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Radiology Associates LLPGroup PAC ID 3779578000, 154 clinicians

Practice addresses (Care Compare)

401 W Campbell Rd
Richardson Regional Medical Center
Richardson, TX 75080-3416
Phone (972) 231-1441

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.4 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT199111PAMDInternal Medicine Physician
S0502TXMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Internal Medicine Current Accepting new patients
Texas Radiology Associates LLP Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center CurrentSince Dec 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Dec 1, 2022 Accepting new patients
Utmb Faculty Group Practice Internal Medicine CurrentSince Oct 5, 2020 Accepting new patients
Texas Tech University Health Sciences Center Odessa Internal Medicine Past Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

132 E Hospital Dr
Angleton, TX 77515
Phone (210) 629-3866

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

3535 S Interstate 35 E
Denton, TX 76210
Phone (940) 384-3013

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

1820 Preston Park Blvd
Ste 2400
Plano, TX 75093

401 W Campbell Rd
Richardson, TX 75080
Phone (940) 384-3535

200 Blossom St
Webster, TX 77598
Phone (281) 252-7000

Organizations & group practices 7

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 2

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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1144513177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-6000",
            "fax_number": "915-545-6607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADAELIL",
        "first_name": "THOMAS",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-24",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT199111",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2016009664",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TX",
            "license": "S0502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.