DR. WILLIAM J. MALLORY (M.D.) – Diagnostic Radiology Physician, NPI 1083630776

DR. WILLIAM J. MALLORY (M.D.) is a healthcare provider. based in Green bay, Wisconsin. specializing in Diagnostic Radiology Physician. They hold the professional credentials M.D.. They hold a License No. 22719-020 (WI). The NPI Number for DR. WILLIAM J. MALLORY (M.D.) is 1083630776

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLIAM J. MALLORY (M.D.)
NPI
1083630776
Phone
(920) 336-4096
Address
2941 S RIDGE RD
Enumeration Date
14 July 2006
Last Update Date
2 June 2008

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
8887882070
Graduation Year
1978 (48 years ago)
PAC ID
2769483833
Group Practice PAC ID
7113908310
Professional Enrollment ID
I20070117000125
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. WILLIAM J. MALLORY (M.D.)

  • South Ridge Road, Lombardi, Green Bay, Brown County, Wisconsin, 54304, United States

    GREEN BAY, WI 543045517

    Phone: (920) 336-4096

    Fax: (920) 336-8093

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-01-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070117000125IDiagnostic RadiologyWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view4235$0
View full utilization report →

Insurance plans in this area (ZIP 54304)

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Provider's Procedures

DR. WILLIAM J. MALLORY (M.D.) performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYWI71250CT scan chest216186
DIAGNOSTIC RADIOLOGYWI73110X-ray of wrist, minimum of 3 views1312
DIAGNOSTIC RADIOLOGYWI73562X-ray of knee, 3 views3834
DIAGNOSTIC RADIOLOGYWI73630X-ray of foot, minimum of 3 views3533
DIAGNOSTIC RADIOLOGYWI76830Ultrasound pelvis through vagina1715
DIAGNOSTIC RADIOLOGYWI78815Nuclear medicine study with CT imaging skull base to mid-thigh7362

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113908310View full group profile
NameSpecialtyState
Interventional Radiology, Diagnostic RadiologyWI
Diagnostic Radiology, Interventional RadiologyWI
-WI
-WI
Diagnostic Radiology, Interventional RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyWI

Reviews

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Frequently asked questions

Can I verify DR. WILLIAM J. MALLORY (M.D.) with an NPI only?
You can start verification with NPI 1083630776 for DR. WILLIAM J. MALLORY (M.D.), then check state licensing separately.
Does CMS list DR. WILLIAM J. MALLORY (M.D.) as active?
Yes — DR. WILLIAM J. MALLORY (M.D.) is active in the NPI listing used on this page.
What is DR. WILLIAM J. MALLORY (M.D.)'s primary classification?
Diagnostic Radiology Physician is the headline specialty for DR. WILLIAM J. MALLORY (M.D.) here. Clinical services aligned with this taxonomy classification.
Where is DR. WILLIAM J. MALLORY (M.D.) based?
DR. WILLIAM J. MALLORY (M.D.) is tied to Green Bay, Wisconsin in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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