Individual provider Active NPI

Mary Patricia Mortell, M.D.

  • Gastroenterology Physician
  • Ann Arbor, MI
National Provider Identifier
1851370142
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301406545 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jan 13, 2006
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 406545 MI
Gastroenterology Physician 207RG0100X 4301406545 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 434-6262

Other identifiers 7

IdentifierTypeStateIssuer
2359882001OtherMICIGNA
020022OtherMIMIDWEST HEALTH PLAN
2769932MedicaidMI
0H14989OtherMIBCBS GROUP
10004002OtherMIMEDICARE RAILROAD PTAN
0812110OtherMIBCBS INDIVIDUAL
4404019OtherMIAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001287 MI Practitioner - Gastroenterology 7315935715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr
Suite 0331
Ann Arbor, MI 48109-0999
Phone (734) 936-5738

1500 E Medical Ctr 2ND Floor Rec
Taubman Center
Ann Arbor, MI 48109-0999
Phone (734) 936-5020

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 1St Flo
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 1St Floor
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 2ND LR
Med Inn
Ann Arbor, MI 48109-0999
Phone (734) 763-5459

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

1500 E Medical Ctr Dr B2 Floor R
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 936-6274

1500 E Medical Ctr Dr Level B
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 647-8901

380 Parkland PLZ
Ann Arbor, MI 48103-6201
Phone (734) 998-7380

39901 Traditions Dr
Northville, MI 48168-9493
Phone (888) 287-1082

4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-6831

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (888) 287-1082

7500 Challis Rd
Brighton, MI 48116-9416
Phone (810) 263-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
406545MIMDGastroenterology Physician
4301406545MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Gastroenterology CurrentSince Apr 25, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Apr 25, 2023 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1851370142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 Elliott Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481978632",
            "country_code": "US",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORTELL",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "406545",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301406545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2359882001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "020022",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2769932",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0H14989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "10004002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0812110",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4404019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.