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

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: August 02, 2026.

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
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

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

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.

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.

Internal Medicine (Interventional Cardiology)
41 MALL RD
BURLINGTON, MA 01805
Hospitalist
41 MALL RD
BURLINGTON, MA 01805
Registered Nurse
41 MALL RD
BURLINGTON, MA 01805
Nurse Practitioner
41 MALL RD
BURLINGTON, MA 01805
Pharmacist
41 MALL RD
BURLINGTON, MA 01805
Student in an Organized Health Care Education/Training Program
41 MALL RD
BURLINGTON, MA 01805
Physician Assistant
41 MALL RD
BURLINGTON, MA 01805
Nurse Practitioner
41 MALL RD
BURLINGTON, MA 01805

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 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.

Where is Hector Madariaga located?

Hector Madariaga practices at 41 Mall Rd, Burlington, MA 01805. The listed phone number is (781) 744-8430.

What is Hector Madariaga's specialty?

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

Is Hector Madariaga enrolled in Medicare?

Yes. Hector Madariaga 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.

Is Hector Madariaga affiliated with any hospitals?

According to CMS data, Hector Madariaga is affiliated with Tufts Medical Center.

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.