DR. WILLIAM J. MALLORY M.D.
NPI 1083630776
Radiology - Diagnostic Radiology in Green Bay, WI
About Dr. William J. Mallory M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WILLIAM J. MALLORY M.D. (NPI 1083630776) is an individual diagnostic radiology provider in Green Bay, Wisconsin, licensed in Wisconsin (22719-020) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Marietta Memorial Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1978).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. William J. Mallory M.d. 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.
Medicare Billing Reassignments
8Medicare enrollment records show William Mallory reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 26 clinicians in this Medicare group
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 742 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 673 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 28 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 4,609 clinicians in this Medicare group
Milwaukee, WI 53209
- Reassigned Medicare billing, Wisconsin enrollment
- 1,615 clinicians in this Medicare group
Saint Francis, WI 53235
- Reassigned Medicare billing, Wisconsin enrollment
- 960 clinicians in this Medicare group
Columbus, OH 43214
- Reassigned Medicare billing, Wisconsin enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Marietta Memorial Hospital
Acute Care Hospitals · Marietta, OHSelby General Hospital
Critical Access Hospitals · Marietta, OHBay Area Medical Center
Acute Care Hospitals · Marinette, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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
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.
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 William Mallory's NPI number?
The NPI number for William Mallory is 1083630776. It was assigned to this individual provider in the NPPES registry on July 14, 2006.
Where is William Mallory located?
William Mallory practices at 2941 S Ridge Rd, Green Bay, WI 54304. The listed phone number is (920) 336-4096.
What is William Mallory's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is William Mallory enrolled in Medicare?
Yes. William Mallory 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.
Which organizations bill Medicare for William Mallory's services?
According to the CMS Revalidation Reassignment List (October 2026 release), William Mallory reassigns Medicare benefits to 8 organizations: Green Bay Radiology Sc (Green Bay, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Green Bay, WI), St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (Sheboygan, WI), Gbr Sheboygan LLC (Sheboygan, WI), Aurora Medical Group, Inc. (Sheboygan, WI) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for William Mallory's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does William Mallory accept?
Health plans from CareSource (Common Ground Healthcare) list William Mallory as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is William Mallory affiliated with any hospitals?
According to CMS data, William Mallory is affiliated with Marietta Memorial Hospital, Selby General Hospital and Bay Area Medical Center.
When was this NPI record last updated?
The NPPES record for William Mallory was last updated on June 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. William J. Mallory, M.D. · NPI 1083630776
Diagnostic Radiology physician in Green Bay, Wisconsin. Individual provider, active in the CMS NPPES registry since July 14, 2006.
## Identity
- **NPI:** 1083630776 (Entity type: Individual)
- **Enumerated:** July 14, 2006
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** 22719-020 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 2941 S RIDGE RD, Green Bay, WI 54304-5517
- **Phone:** (920) 336-4096 · **Fax:** (920) 336-8093
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): Green Bay Radiology Sc (NPI 1447327986, Green Bay, WI); St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (NPI 1285613638, Green Bay, WI); St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (NPI 1275799413, Sheboygan, WI); Gbr Sheboygan LLC (NPI 1467529917, Sheboygan, WI); Aurora Medical Group, Inc. (NPI 1174670244, Sheboygan, WI); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Wisconsin School Of Medicine, class of 1978
## Record status
- **NPPES last updated:** June 2, 2008
- **Other identifiers:** Medicaid 31370200 (WI); Medicare UPIN B54781; Medicare PIN 002407201 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1083630776) · Data from the CMS NPPES public registry.