DR. KEVIN L MORTARA MD
NPI 1033109210
Internal Medicine - Hematology & Oncology in Green Bay, WI

Q: What is Kevin Mortara's NPI number?

The NPI number for Kevin Mortara is 1033109210. It was assigned to this individual provider in the NPPES registry on October 27, 2005.

Q: What is Kevin Mortara's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Mortara was last updated on June 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 October 27, 2005PECOS Enrolled

1580 COMMANCHE AVE, GREEN BAY, WI 54313(920) 435-8326(920) 430-4659 Get Directions Write a Review

NPPES record last updated: June 12, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Kevin L Mortara Md NPPES

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

DR. KEVIN L MORTARA MD (NPI 1033109210) is an individual hematology & oncology provider in Green Bay, Wisconsin, licensed in Wisconsin (48997-20) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033109210

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameDR. KEVIN L MORTARACredential: MD

Location Address1580 COMMANCHE AVEGreen Bay, WI 54313-5751

Mailing Address1580 Commanche AveGreen Bay, WI 54313-5751 · (920) 435-8326 · Fax (920) 430-4659

Phone(920) 435-8326

Fax(920) 430-4659

Sole ProprietorNo

Enumeration DateOctober 27, 2005

Last NPPES UpdateJune 12, 2014

✔ NPI 1033109210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in WI · 48997-20

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

1580 COMMANCHE AVE, Green Bay, WI 54313

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Other Identifiers 1

Medicare OSCAR/certificationK400140496WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin L Mortara Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Kevin Mortara reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bellin Memorial Hospital Inc

Same address

Family Medicine

1580 COMMANCHE AVE
Green Bay, WI 54313

Reassigned Medicare billing, Wisconsin enrollment
875 clinicians in this Medicare group

NPI 1124081484 (920) 445-7295

Oconto Hospital & Medical Center, Inc.

27 mi

Rural Health

107 E HIGHLAND DR
Oconto Falls, WI 54154

Reassigned Medicare billing, Wisconsin enrollment
Also billed through NPI 1356373302 (Wisconsin)
573 clinicians in this Medicare group

NPI 1063038313 (920) 846-3092

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 2

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

108 services77 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

72 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54313 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

$163.24 typical visit price

range $53.90 – $163.24

Typical copayment $40.81 (range $13.47 – $40.81)

Most-billed visit code 99205

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Temozolomide, oral, 5 mg J8700

Treatment-Treatment - Miscellaneous · category RX000N

2 suppliers11 claims435 services$0.92 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

2 suppliers16 claims16 services$12.74 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.

KRYSTINA L PUTNAM APNP

Nurse Practitioner (Family)