Active NPI
Joseph Ben Mallory, M.D.
- Diagnostic Radiology Physician
- Edina, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036063108
- Practice address
- 3600 Minnesota Dr Ste 800
Edina, MN 55435-7915 - Phone
- (612) 595-1100
- Fax
- (612) 294-4903
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036063108 | IL | Primary |
Addresses
Primary practice location
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Mailing address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (612) 595-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05032053 | Other | IL | BCBS OF IL |
| 036063108 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MT, IA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7000
12801 Hacienda RDG
Austin, TX 78738-7652
Phone (713) 461-3573
1740 Little Willow Rd
Morris, IL 60450-6846
Phone (952) 595-1100
3614 Victoria Ave
Mount Vernon, IL 62864-2208
Phone (952) 595-1100
Hospital & facility affiliations
- Portsmouth Regional Hospital
- Medical Center Hospital
- Ozarks Healthcare
- Carle Foundation Hospital
- Allen Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036063108 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtual Radiologic Professionals, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Sidney Health Center | Current | Accepting new patients | |
| Belmond Community Hospital | Current | Accepting new patients | |
| Iowa Specialty Hospital- Clarion | Current | Accepting new patients | |
| Belmond Community Hospital | Current | Accepting new patients | |
| Iowa Specialty Hospital- Clarion | Current | Accepting new patients | |
| Sidney Health Center | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Central Montana Medical Facilities, Inc | Current | Accepting new patients | |
| Fred Smeltzer MD & Associates Inc | Diagnostic Radiology | Current | Accepting new patients |
| Midwest Radiology Associates SC | Diagnostic Radiology | Past | Accepting new patients |
| Morris Radiology Associates, Inc | Diagnostic Radiology | Past | Accepting new patients |
| Ozarks Medical Center | Diagnostic Radiology | Past | Accepting new patients |
| Triumph Radiology Inc | Past | Accepting new patients | |
| Ottowa Imaging LLC | Diagnostic Radiology | Past | Accepting new patients |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| GMG Health Systems Associates PA | Past | Accepting new patients |
Locations
403 1st St SE
Belmond, IA 50421
Phone (641) 444-3223
1316 S Main St
Clarion, IA 50525
Phone (515) 532-2811
3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
621 3rd St S
Glasgow, MT 59230
Phone (406) 228-3500
Organizations & group practices 20
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.
-
- Diagnostic Radiology Physician
- Shenandoah, TX
- NPI 1538107875
-
- Critical Access Hospital
- Belmond, IA
- NPI 1932142726
-
- Critical Access Hospital
- Lewistown, MT
- NPI 1790798387
-
- Critical Access Hospital
- Clarion, IA
- NPI 1821045451
-
- Critical Access Hospital
- Vandalia, IL
- NPI 1912988734
-
- Critical Access Hospital
- Sidney, MT
- NPI 1285719161
-
- Diagnostic Radiology Physician
- Ottawa, IL
- NPI 1962599027
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Waterloo, IA
- NPI 1336231091
-
- Federally Qualified Health Center (FQHC)
- Odessa, TX
- NPI 1578265302
Hospital
-
- General Acute Care Hospital
- Odessa, TX
- NPI 1740273994
-
- General Acute Care Hospital
- Portsmouth, NH
- NPI 1518913607
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1649367251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 MINNESOTA DR STE 800",
"city": "EDINA",
"state": "MN",
"postal_code": "554357915",
"telephone_number": "612-595-1100",
"fax_number": "612-294-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MINNESOTA DR STE 800",
"city": "EDINA",
"state": "MN",
"postal_code": "554357915",
"telephone_number": "612-595-1100",
"fax_number": "612-294-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLORY",
"first_name": "JOSEPH",
"middle_name": "BEN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036063108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "05032053",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036063108",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.