KOENRAAD MAX MORTELE NPI 1942285986

NPI Information

  • NPI: 1942285986
  • Provider Name: KOENRAAD MAX MORTELE
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 75 FRANCIS ST
    RADIOLOGY BRIGHAMT WOMENS HOSPITAL
    BOSTON, MA
    ZIP 02115
  • Phone: (617) 732-7624

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NPI Details

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
12085R0202XRadiologyDiagnostic Radiology223120MASSACHUSETTSYes

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
1H54579MEDICARE UPIN
2J24540OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
3213484OTHERMASSACHUSETTSTUFTS HEALTH CARE
4A33528MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS

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: 11/21/2025

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