Individual provider Active NPI

Timothy Madden, M.D.

  • Diagnostic Radiology Physician
  • Kingston, NY
National Provider Identifier
1821225368
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
279192 Issued in NY
Practice address
45 Pine Grove Ave
Kingston, NY 12401-5407
Phone
(845) 340-4500
Fax
(845) 340-4501
NPI assigned
Jun 11, 2009
Last updated
May 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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 279192 NY Primary

Addresses

Primary practice location

45 Pine Grove Ave
Kingston, NY 12401-5407

Mailing address

45 Pine Grove Ave
Kingston, NY 12401-5407
Phone (845) 340-4500

Other practice location 1

42084 State Highway 28
Margaretville, NY 12455-2820
Phone (845) 586-2631

Other practice location 2

396 Broadway
Kingston, NY 12401-4626
Phone (845) 331-3131

Other practice location 3

105 Marys Ave
Kingston, NY 12401-5848
Phone (845) 338-2500

Other identifiers 1

IdentifierTypeStateIssuer
04181435MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190429001186 PA Practitioner - Diagnostic Radiology 2961713714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians
Main Line Health Imaging LPGroup PAC ID 7618867664, 51 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-2263

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3120
Phone (610) 526-8390

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-3005

120 Valley Green LN
King of Prussia, PA 19406-2079
Phone (866) 225-5654

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4123

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8590

154 Exton Square Pkwy
Exton, PA 19341-2440
Phone (610) 280-6103

1991 Sproul Rd
Broomall, PA 19008-3512
Phone (484) 476-3700

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-8068

3855 W Chester Pike
Newton Square, PA 19073-2304
Phone (484) 337-6149

599 Arcola Rd
Collegeville, PA 19426-3954
Phone (484) 565-8430

80 Lancaster Ave
Devon, PA 19333-1331
Phone (484) 526-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Health Imaging LP Diagnostic Radiology CurrentSince May 1, 2019 Accepting new patients
Radiology Associates of the Main Line P C Diagnostic Radiology CurrentSince May 1, 2019 Accepting new patients
Main Line Healthcare PastSince Jul 31, 2010 Accepting new patients

Locations

1991 Sproul Rd
Broomall, PA 19008
Phone (484) 476-3700

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 526-2200

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

599 Arcola Rd
Collegeville, PA 19426
Phone (484) 565-8440

154 Exton Square Mall
Exton, PA 19341
Phone (484) 565-8500

1020 Baltimore Pike
Glen Mills, PA 19342
Phone (484) 227-7777

120 Valley Green Ln
Kng of Prussa, PA 19406
Phone (610) 526-3000

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

3855 West Chester Pike
Newtown Square, PA 19073
Phone (484) 337-6000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

306 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 476-7222

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1821225368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PINE GROVE AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015407",
            "telephone_number": "845-340-4500",
            "fax_number": "845-340-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PINE GROVE AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015407",
            "telephone_number": "845-340-4500",
            "fax_number": "845-340-4501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42084 State Highway 28",
            "address_purpose": "LOCATION",
            "city": "Margaretville",
            "state": "NY",
            "postal_code": "124552820",
            "country_code": "US",
            "telephone_number": "845-586-2631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "396 Broadway",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124014626",
            "country_code": "US",
            "telephone_number": "845-331-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Marys Ave",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124015848",
            "country_code": "US",
            "telephone_number": "845-338-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "279192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04181435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.