JOHN C. MADORE M.D.
NPI 1609262328
Surgery - Surgical Critical Care in Worcester, MA

Active since April 09, 2015PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(508) 856-5288(508) 856-4224 Get Directions Write a Review

NPPES record last updated: August 3, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 3, 2021, Jun 18, 2020 (2 updates tracked since 2020).

About John C. Madore M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN C. MADORE M.D. (NPI 1609262328) is an individual surgical critical care provider in Worcester, Massachusetts, licensed in Massachusetts (288947) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1609262328
Entity TypeIndividualMale
Primary Taxonomy2086S0102X
Provider Legal NameJOHN C. MADORECredential: M.D.
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Fax(508) 856-4224
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2015
Enumeration DateApril 9, 2015
Last NPPES UpdateAugust 3, 20212 updates tracked since enumeration
NPPES CertifiedAugust 3, 2021
NPI 1609262328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians
Taxonomy Code2086S0102X
License Licensed in MA · 288947
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedSurgeryTaxonomy 208600000X · License 2020016522 (MO), 263564 (MA)
55 LAKE AVE N, Worcester, MA 01655

Secondary Practice Location 1

Location 11 Barnes Jew Hosp PlzSaint Louis, MO 63110-1003 · Phone (314) 362-5000

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John C. Madore M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204143266
PECOS Enrollment IDI20210818000032
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
503 services270 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
141 services51 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
92 services92 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
55 services33 patients
Emergency department visit with straightforward medical decision making 99282
An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
46 services46 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
33 services33 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220019
Location100 South StreetSouthbridge, MA 01550 · Worcester County
Emergency services

Umass Memorial Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220049
Location157 Union StreetMarlborough, MA 01752 · Middlesex County
Emergency services

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220090
Location14 Prospect StreetMilford, MA 01757 · Worcester County
Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Madore's NPI number?

The NPI number for John Madore is 1609262328. It was assigned to this individual provider in the NPPES registry on April 9, 2015.

Where is John Madore located?

John Madore practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 856-5288.

What is John Madore's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Is John Madore enrolled in Medicare?

Yes. John Madore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Madore accept?

Health plans from Anthem Blue Cross and Blue Shield list John Madore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is John Madore affiliated with any hospitals?

According to CMS data, John Madore is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Health - Harrington Hospital, Umass Memorial Healthcare-Marlborough Hospital, Milford Regional Medical Center and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for John Madore was last updated on August 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.