Individual provider Active NPI

Joseph Ben Mallory, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1649367251
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036063108 Issued in IL
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

Updated by the provider on Mar 10, 2025

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 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

IdentifierTypeStateIssuer
05032053OtherILBCBS OF IL
036063108MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MT, IA, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040723000846 IL Practitioner - Diagnostic Radiology 8820078355 Reassigns benefits to 6 organizations
I20250915003729 MT Practitioner - Diagnostic Radiology 8820078355 Reassigns benefits to 2 organizations
I20251002004192 IA Practitioner - Diagnostic Radiology 8820078355 Reassigns benefits to 2 organizations
I20260628000225 TX Practitioner - Diagnostic Radiology 8820078355 Reassigns benefits to 1 organization

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
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians
Virtual Radiologic Professionals LLCGroup PAC ID 4981608817, 392 clinicians
Monadnock Community HospitalGroup PAC ID 7416933031, 67 clinicians

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 Hospital, Portsmouth, NH, CCN 300029
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132
  • Ozarks Healthcare Hospital, West Plains, MO, CCN 260078
  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
  • Allen Hospital Hospital, Waterloo, IA, CCN 160110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036063108ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Apr 24, 2025 Accepting new patients
Sidney Health Center CurrentSince Oct 5, 2025 Accepting new patients
Belmond Community Hospital Current Accepting new patients
Iowa Specialty Hospital- Clarion Current Accepting new patients
Belmond Community Hospital CurrentSince Sep 1, 2025 Accepting new patients
Iowa Specialty Hospital- Clarion CurrentSince Sep 1, 2025 Accepting new patients
Sidney Health Center CurrentSince Oct 5, 2025 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 CurrentSince Nov 20, 2025 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 PastSince Nov 1, 2006 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.

View all 20

Hospital & facility affiliations 7

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": "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

Verify at the official NPI Registry.