Michael Dean Mack, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS12342 Issued in FL

Practice address

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Phone

(563) 742-4850

NPI assigned

Feb 5, 2008

Last updated

Jan 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 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

Specialty

Emergency Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unity HealthcareGroup PAC ID 8224931548, 65 clinicians

Trinity Medical CenterGroup PAC ID 2264337518, shared by 4 NPIs, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Muscatine Hospital, Muscatine, IA, CCN 160013
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmack400465@direct.unitypoint.org

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.

• Unity Healthcare

  dba Unity Physician Clinics

  • Internal Medicine Physician
  • Muscatine, IA
  • NPI 1629122742
  Medicare reassignment Care Compare group NPD
• The Finley Hospital

  dba UnityPoint Clinic

  • Family Medicine Physician
  • Dubuque, IA
  • NPI 1073560462
  Medicare reassignment NPD
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• The Finley Hospital

  dba UnityPoint Health - Provider Services

  • Emergency Medicine Physician
  • Dubuque, IA
  • NPI 1134176308
  NPD
• Unity Healthcare

  dba Unitypoint Clinic - Mulberry

  • Rural Health Clinic/Center
  • Muscatine, IA
  • NPI 1447802400
  NPD
• Unity Healthcare

  dba Trinity Muscatine

  • General Acute Care Hospital
  • Muscatine, IA
  • NPI 1861444333
  NPD

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

• Trinity Medical Center

  dba Trinity Bettendorf

  • General Acute Care Hospital
  • Bettendorf, IA
  • NPI 1124110820
  Care Compare affiliation
• Unity Healthcare

  dba Trinity Muscatine

  • General Acute Care Hospital
  • Muscatine, IA
  • NPI 1861444333
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Rock Island

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1225216997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4578 ASHTON CIR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362258",
            "telephone_number": "515-290-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221644",
            "telephone_number": "563-742-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "3906",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS12342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Ludgate, RD, LD, LDN
• Myles Julian Luszczyk, D.O.
• M Kari Interventional Pain Services PLLC
• Thomas Michael Mabee, M.D.
• Adriana C Macdonald, SLP
• Steven J Mack, DDS MS
• Abbi Ann Madden, D.O.
• Magnus Orthopaedic Clinic, PC
• Kristen Marie Mandle, MOT OTR/S
• Mary Manion, DPT

• Emergency Medicine Physician in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Emergency Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.