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KELLY ELIZABETH MORTELL M.D. NPI 1841434354


NPI Information

NPI: 1841434354
Provider Name: KELLY ELIZABETH MORTELL, M.D.
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

Organization: NORTHWEST RADIOLOGY NETWORK PC

PECOS Registration: Yes

Address:
621 MEMORIAL DR
STE 312
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-5200
Get Directions

Kelly Elizabeth Mortell, M.D. is a vascular and interventional radiology radiology in South Bend, IN with 15 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. Kelly Elizabeth Mortell, M.D. NPI is 1841434354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2009

The provider's business location address is:

621 MEMORIAL DR
STE 312
SOUTH BEND, IN
ZIP 46601-063
Phone: (574) 647-5200

The NPI 1841434354 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

The enumeration date for this NPI number is 4/28/2009 and was last updated on 12/6/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0204XRadiologyVascular & Interventional Radiology01075131AINDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000928326OTHERINDIANABCBS BMG VASCULAR INTERVENTIONAL RADIOLOGY
2000000951355OTHERINDIANABCBS BMG VEIN SPECIALIST
3201289120MEDICAIDINDIANA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.