Timothy Mack

Primary specialty

OptometristTaxonomy code 152W00000X

License

6297 Issued in OH

Practice address

7990 Severhill CT
Dublin, OH 43016-9235

Phone

(614) 946-1453

NPI assigned

Jun 12, 2014

Last updated

Jun 14, 2014By 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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Family Eye Care OD PLLCGroup PAC ID 8123159324, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Premier Family Eye Care OD PLLC

  • Optometrist
  • Indian Trail, NC
  • NPI 1063739274
  Medicare reassignment Care Compare group NPD Authorized official
• Poarch Band of Creek Indians Dba Premier Family Eye Care

  • Optometrist
  • Atmore, AL
  • NPI 1336257575
  NPD (past)

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402704000000",
    "number": "1225442767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7990 SEVERHILL CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7990 SEVERHILL CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169235",
            "telephone_number": "614-946-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6297",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "6297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Rebecca Macdonald
• Angela Macek, LPC
• Amber Murphy Mack, M.D
• Eric Lamont Mack Jr., DC, BS
• Teresa Mack
• Amanda Mackall
• Scott T Mackey, M.D.
• Julia Marie Madick, PMHNP-BC
• Casey Madore
• Marisa Dreisbach Maffett, MD

• Optometrist in Dublin, OH
• Providers in Dublin, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2014; 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.