Individual provider

Mark Kettler, MD

Diagnostic Radiology Physician Medicare enrolled

Mark Kettler, MD is a Diagnostic Radiology Physician in Boston, MA, registered under NPI 1790790202.

Getting there

The practice address on file is 820 HARRISON AVE BUILDING FGH-3 ROOM 203, Boston, MA 02118. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

820 HARRISON AVE BUILDING FGH-3 ROOM 203, Boston, MA 02118 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
MD15140 OR Diagnostic Radiology Physician primary
234438 MA Diagnostic Radiology Physician

Licences are recorded in 2 states: OR, MA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Diagnostic Radiology
PAC ID
2961394671
Enrollment ID
I20040326001357

Medicare enrolment is recorded as approved under the provider type Practitioner - Diagnostic Radiology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Massachusetts and Oregon. The practice address on file is in Boston, MA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

MA Massachusetts practice address
Licence
234438
Specialty
Diagnostic Radiology Physician
Verify with the MA board →
OR Oregon
Licence
MD15140
Specialty
Diagnostic Radiology Physician
Verify with the OR board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Diagnostic Radiology covers

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NUCC Health Care Provider Taxonomy, code 2085R0202X
Allopathic & Osteopathic Physicians Radiology Diagnostic Radiology

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
2085R0202X Diagnostic Radiology Physician Diagnostic Radiology MD15140 OR primary
2085R0202X Diagnostic Radiology Physician Diagnostic Radiology 234438 MA

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1790790202 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJul 31, 2006
Last updatedJan 31, 2008
StatusActive
Sole proprietorNo
CredentialMD
Practice address 820 HARRISON AVE
BUILDING FGH-3 ROOM 203
Boston, MA 02118
(617) 638-6610
Fax (617) 638-6616
Other identifiers 018593 · Medicaid (OR)
This record was last updated on Jan 31, 2008, roughly 18 years ago. Address and phone details that old are frequently out of date. Verify by phone before travelling to the address shown.

Number check

1790790202 passes the NPI check digit test The final digit 2 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 7 9 0 7 9 0 2 0
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 7 9 0 5 9 0 2 0

Sum = 58 · next multiple of 10 = 60 · check digit = 2 · actual last digit = 2

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1790790202?
NPI 1790790202 is the National Provider Identifier assigned to Mark Kettler, MD in Boston, MA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Diagnostic Radiology cover?
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
How do I contact Mark Kettler, MD?
The phone number on file with NPPES is (617) 638-6610, last updated Jan 31, 2008. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Mark Kettler, MD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1790790202 a valid number?
Yes. 1790790202 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.