DR. HECTOR M MADARIAGA MD
NPI 1992010375
Internal Medicine - Nephrology in Burlington, MA

Q: What is Hector Madariaga's NPI number?

The NPI number for Hector Madariaga is 1992010375. It was assigned to this individual provider in the NPPES registry on August 10, 2010.

Q: What is Hector Madariaga's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Hector Madariaga was last updated on August 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 10, 2010PECOS EnrolledAccepts Medicare Assignment

41 MALL RD, BURLINGTON, MA 01805(781) 744-8430(781) 744-5397 Get Directions Write a Review

NPPES record last updated: August 4, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Hector M Madariaga Md NPPES

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

DR. HECTOR M MADARIAGA MD (NPI 1992010375) is an individual nephrology provider in Burlington, Massachusetts, licensed in Massachusetts (265696) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS, is affiliated with Tufts Medical Center, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1992010375

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. HECTOR M MADARIAGACredential: MD

Location Address41 MALL RDBurlington, MA 01805-0001

Mailing Address41 Mall RdBurlington, MA 01805-0001 · (781) 744-8430 · Fax (781) 744-5397

Phone(781) 744-8430

Fax(781) 744-5397

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateAugust 10, 2010

Last NPPES UpdateAugust 4, 2021

NPPES CertifiedAugust 4, 2021

✔ NPI 1992010375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in MA · 265696

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

41 MALL RD, Burlington, MA 01805

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Hector M Madariaga Md 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 ID1850690900

PECOS Enrollment IDI20161013000439

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.

Medicare Billing Reassignments

Medicare enrollment records show Hector Madariaga reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Steward Medical Group, Inc

10 mi

Specialist

9 GALEN ST
Watertown, MA 02472

Reassigned Medicare billing, Massachusetts enrollment
1,103 clinicians in this Medicare group

NPI 1629398219 (615) 467-4474

Lahey Clinic, Inc

12 mi

Internal Medicine

1 ESSEX CENTER DR
Peabody, MA 01960

Reassigned Medicare billing, Massachusetts enrollment
1,841 clinicians in this Medicare group

NPI 1063447316 (781) 744-8000

Pratt Medical Group, Inc

13 mi

Gastroenterology

800 WASHINGTON ST, BOX 1013
Boston, MA 02111

Reassigned Medicare billing, Massachusetts enrollment
334 clinicians in this Medicare group

NPI 1013237809 (617) 636-5000

Pratt Surgical Associates Inc

13 mi

Surgery

800 WASHINGTON ST, BOX 1013
Boston, MA 02111

Reassigned Medicare billing, Massachusetts enrollment
72 clinicians in this Medicare group

NPI 1912944182 (617) 636-5000

Sound Physicians Of Massachusetts, Inc

26 mi

Internal Medicine

150 YORK ST
Stoughton, MA 02072

Reassigned Medicare billing, Massachusetts enrollment
337 clinicians in this Medicare group

NPI 1245784446 (781) 344-0600

Sound Physicians Of Massachusetts II PC

30 mi

Internal Medicine

235 N PEARL ST
Brockton, MA 02301

Reassigned Medicare billing, Massachusetts enrollment
173 clinicians in this Medicare group

NPI 1306376397 (615) 377-5658

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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 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.

436 services104 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

217 services61 patients

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.

106 services53 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.

57 services50 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

26 services17 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

23 services22 patients

Hospital Affiliations CMS Care Compare

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

Tufts Medical Center

Acute Care Hospitals · Boston, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220116

Location800 Washington StreetBoston, MA 02111 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.11 typical visit price

range $63.72 – $189.86

Typical copayment $36.02 (range $15.93 – $47.46)

Most-billed visit code 99204

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

72%230 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers24 claims24 services$2.91 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers11 claims3,720 services$0.32 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers15 claims1,920 services$0.19 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

3 suppliers17 claims17 services$18.92 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

3 suppliers12 claims12 services$12.57 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

SAHOOR KHAN

Internal Medicine (Interventional Cardiology)