KOENRAAD MAX MORTELE NPI 1942285986

NPI Information

NPI: 1942285986
Provider Name: KOENRAAD MAX MORTELE
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
75 FRANCIS ST
RADIOLOGY BRIGHAMT WOMENS HOSPITAL
BOSTON, MA
ZIP 02115
Phone: (617) 732-7624
Get Directions

Koenraad Max Mortele is a diagnostic radiology radiology in Boston, MA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Koenraad Max Mortele NPI is 1942285986. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

75 FRANCIS ST
RADIOLOGY BRIGHAMT WOMENS HOSPITAL
BOSTON, MA
ZIP 02115-110
Phone: (617) 732-7624

The enumeration date for this NPI number is 12/13/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	223120	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H54579	MEDICARE UPIN
2	J24540	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD
3	213484	OTHER	MASSACHUSETTS	TUFTS HEALTH CARE
4	A33528	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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