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MARK DAVID KETTLER MD
NPI 1790790202
Radiology - Diagnostic Radiology in Boston, MA

Active since July 31, 2006PECOS Enrolled
97.83/100
CMS Quality Rating
820 HARRISON AVE, BUILDING FGH-3 ROOM 203, BOSTON, MA 02118(617) 638-6610(617) 638-6616 Get Directions Write a Review

NPPES record last updated: January 31, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mark David Kettler Md NPPES

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

MARK DAVID KETTLER MD (NPI 1790790202) is an individual diagnostic radiology provider in Boston, Massachusetts, licensed in Oregon (MD15140) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790790202
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameMARK DAVID KETTLERCredential: MD
Location Address820 HARRISON AVE, BUILDING FGH-3 ROOM 203Boston, MA 02118
Mailing Address820 Harrison Ave, Building Fgh-3 Room 203Boston, MA 02118
Phone(617) 638-6610
Fax(617) 638-6616
Sole ProprietorNo
Enumeration DateJuly 31, 2006
Last NPPES UpdateJanuary 31, 2008
✔ NPI 1790790202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses✔ Licensed in OR · MD15140✔ Licensed in MA · 234438
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
820 HARRISON AVE, Boston, MA 02118
Open in Google Maps ↗

Other Identifiers 2

Medicaid018593OR
Medicare UPINA04889

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark David Kettler 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

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.

97.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.97
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAHNAZ RAHMAN
Radiology (Diagnostic Radiology)
820 HARRISON AVE
BOSTON, MA 02118
Suffolk County (404) 259-4008
NEIL THAYIL MD
Radiology (Diagnostic Radiology)
820 HARRISON AVE, DEPT.OF RADIOLOGY , FGH BUILDING , 3RD FLOOR
BOSTON, MA 02118
Suffolk County (617) 414-5135
JULIAN MARK NICHOLAS MCDONALD MBCHB
Student in an Organized Health Care Education/Training Program
820 HARRISON AVE, BLDG 3
BOSTON, MA 02118
Suffolk County (617) 638-8000
ZOHA HUDA MD
Student in an Organized Health Care Education/Training Program
820 HARRISON AVE
BOSTON, MA 02118
Suffolk County (617) 638-6604
BETTY YANG M.D.
Student in an Organized Health Care Education/Training Program
820 HARRISON AVE, FGH BUILDING, 4TH FLOOR
BOSTON, MA 02118
Suffolk County (415) 968-9264
KENNETH M GRUNDFAST M.D.
Otolaryngology
820 HARRISON AVE, SUITE 4005
BOSTON, MA 02118
Suffolk County (617) 638-7934
JORDAN ANDREW JUSTICE MD
Radiology (Diagnostic Radiology)
820 HARRISON AVE, FGH BUILDING 4TH FLOOR 4404
BOSTON, MA 02118
Suffolk County (617) 638-6604
DR. KHALID I. A. HASSAN M.D.
Radiology (Diagnostic Radiology)
820 HARRISON AVE, FGH BUILDING, 3RD FLOOR
BOSTON, MA 02118
Suffolk County (617) 638-6610

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 Mark Kettler's NPI number?

The NPI number for Mark Kettler is 1790790202. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Where is Mark Kettler located?

Mark Kettler practices at 820 Harrison Ave Building Fgh-3 Room 203, Boston, MA 02118. The listed phone number is (617) 638-6610.

What is Mark Kettler's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mark Kettler enrolled in Medicare?

Yes. Mark Kettler is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Kettler was last updated on January 31, 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.