NPIMap

Individual provider Active NPI

Jeffrey Thomas Maddock, M.D.

  • Diagnostic Radiology Physician
  • Bismarck, ND
National Provider Identifier
1922450790
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
18369 Issued in ND
Practice address
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone
(701) 530-5304
NPI assigned
Jul 6, 2016
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 18369 ND Primary
Vascular & Interventional Radiology Physician 2085R0204X 18369 ND

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501-4520

Mailing address

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-5304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220913001198 ND Practitioner - Interventional Radiology 1759654759 Reassigns benefits to 2 organizations
I20260508000624 ID Practitioner - Diagnostic Radiology 1759654759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of North Dakota School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians
Bismarck Radiology Associates PCGroup PAC ID 9739525569, 4 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Aug 29, 2022 Accepting new patients
St. Alexius Medical Center CurrentSince Aug 29, 2022 Accepting new patients
Sunshine Radiology Contracting PLLC Diagnostic Radiology CurrentSince May 2, 2026 Accepting new patients
Bismarck Radiology Associates PC Diagnostic Radiology CurrentSince Jan 3, 2024 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 5

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1922450790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOCK",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "18369",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ND",
            "license": "18369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.