Individual provider Active NPI

Christopher Martin Mager, MD

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1407084478
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
74857-20 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 433-3643
Fax
(507) 625-3928
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 53947 MN
Diagnostic Radiology Physician 2085R0202X 2012011152 MO
Diagnostic Radiology Physician 2085R0202X 74857-20 WI Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

1789 Shawano Ave
Green Bay, WI 54303-3243
Phone (920) 499-1428

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christophermager@mklt.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210517001602 WI Practitioner - Diagnostic Radiology 3678737913 Reassigns benefits to 2 organizations
I20210527001138 MI Practitioner - Diagnostic Radiology 3678737913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology CharteredGroup PAC ID 1557394988, 39 clinicians

Practice addresses (Care Compare)

Marquette, MI 49855
Phone (920) 499-2766

1789 Shawano Ave
Green Bay, WI 54303-3243
Phone (920) 499-1428

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012011152MOMDDiagnostic Radiology Physician
74857-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince May 26, 2021 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Jul 5, 2021 Accepting new patients
Radiology Chartered Diagnostic Radiology CurrentSince Jul 5, 2021 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 9, 2021 Accepting new patients

Locations

610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1789 Shawano Ave
Green Bay, WI 54303

725 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-7995

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1407084478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033243",
            "telephone_number": "920-499-1428",
            "fax_number": "920-499-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3643",
            "fax_number": "507-625-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGER",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "53947",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2012011152",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "74857-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christophermager@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1230 E Main St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.