Koenraad Max Mortele

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

223120 Issued in MA

Practice address

75 Francis St
Radiology Brighamt Womens Hospital
Boston, MA 02115-6110

Phone

(617) 732-7624

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1942285986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "RADIOLOGY BRIGHAMT WOMENS HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "RADIOLOGY BRIGHAMT WOMENS HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTELE",
        "first_name": "KOENRAAD",
        "middle_name": "MAX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "223120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH CARE",
            "identifier": "213484",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J24540",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ned Wilson Morse
• Samantha Morse, PA-C
• Chermaine L Morson, PHLEBOTOMIST
• Elizabeth A Mort, MD
• Samira Sadat Mortazavi, OD
• Rachel Mortell, RN, FNP-C
• Jamie C. Mortellite, NURSE PRACTITIONER
• Peter J. Mortelliti, DDS.
• Lindsey Mortensen, MD
• Gino A Mortillaro, M.D.

• Diagnostic Radiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.