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DR. KOTI R MANNEM MD
NPI 1720188717
Psychiatry & Neurology - Psychiatry in Green Bay, WI

Active since September 22, 2006PECOS Enrolled
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311(920) 391-4700(920) 391-4870 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Koti R Mannem Md NPPES

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

DR. KOTI R MANNEM MD (NPI 1720188717) is an individual psychiatry provider in Green Bay, Wisconsin, licensed in Wisconsin (24001) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1974).

NPPES Registry Identity

NPI1720188717
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. KOTI R MANNEMCredential: MD
Location Address3150 GERSHWIN DRIVEGreen Bay, WI 54311-5859
Mailing Address3150 Gershwin DriveGreen Bay, WI 54311-5859 · (920) 391-4700 · Fax (920) 391-4870
Phone(920) 391-4700
Fax(920) 391-4870
Sole ProprietorNo
Medical School CMSOtherGraduated 1974
Enumeration DateSeptember 22, 2006
Last NPPES UpdateMarch 17, 2025
NPPES CertifiedMarch 17, 2025
✔ NPI 1720188717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in WI · 24001
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
3150 GERSHWIN DRIVE, Green Bay, WI 54311
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Other Identifiers 1

Medicaid1720188717WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Koti R Mannem Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911964200
PECOS Enrollment IDI20041218000041
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

5

Medicare enrollment records show Koti Mannem reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Brown
Same address
Psychiatry
3150 GERSHWIN DRIVE
Green Bay, WI 54311
  • Reassigned Medicare billing, Wisconsin enrollment
  • 24 clinicians in this Medicare group
NPI 1679747059 (920) 391-4700
Oneida County
106 mi
Mental Health (Including Community Mental Health Center)
705 E TIMBER DR
Rhinelander, WI 54501
  • Reassigned Medicare billing, Wisconsin enrollment
  • 6 clinicians in this Medicare group
NPI 1780418392 (715) 369-2215
The Human Service Center
106 mi
Community/Behavioral Health
705 E TIMBER DR
Rhinelander, WI 54501
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2 clinicians in this Medicare group
NPI 1215985403 (715) 362-7463
Counseling & Development Center
145 mi
Mental Health
171 CHESTNUT ST
Phillips, WI 54555
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2 clinicians in this Medicare group
NPI 1760524854 (715) 339-3048
Aurora Counseling Centers Employee Support Systems, Inc.
197 mi
Professional
406 TECHNOLOGY DR E, SUITE C
Menomonie, WI 54751
  • Reassigned Medicare billing, Wisconsin enrollment
  • 19 clinicians in this Medicare group
NPI 1437240868 (715) 235-4696

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.
317 services101 patients
Telehealth originating site facility fee Q3014
The Telehealth originating site facility fee is a charge for the location where you receive your telehealth service, such as a clinic or hospital. It covers costs like equipment use, technical support, and other resources needed to provide a secure, effective telehealth visit.
131 services60 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 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
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

COUNTY OF BROWN
Skilled Nursing Facility
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-4700
COUNTY OF BROWN
Case Management
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-4839
SEANAH A CARTER APSW
Social Worker (Clinical)
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-4700
STEVEN G JANSEN MSW
Social Worker (Clinical)
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-6940
COUNTY OF BROWN
Case Management
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-4839
MARY MICELI-WINK CSAC
Counselor (Addiction (Substance Use Disorder))
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-6940
SUSAN F ALBERTSON LPN
Licensed Practical Nurse
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-6940
COUNTY OF BROWN
Case Management
3150 GERSHWIN DRIVE
GREEN BAY, WI 54311
Brown County (920) 391-4839

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 Koti Mannem's NPI number?

The NPI number for Koti Mannem is 1720188717. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Koti Mannem located?

Koti Mannem practices at 3150 Gershwin Drive, Green Bay, WI 54311. The listed phone number is (920) 391-4700.

What is Koti Mannem's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Koti Mannem enrolled in Medicare?

Yes. Koti Mannem is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Koti Mannem's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Koti Mannem reassigns Medicare benefits to 5 organizations: County Of Brown (Green Bay, WI), Oneida County (Rhinelander, WI), The Human Service Center (Rhinelander, WI), Counseling & Development Center (Phillips, WI) and Aurora Counseling Centers Employee Support Systems, Inc. (Menomonie, WI). 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 Koti Mannem's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Koti Mannem accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan, Network Health and Quartz and 2 other insurers list Koti Mannem 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.

When was this NPI record last updated?

The NPPES record for Koti Mannem was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.