NPIMap

Individual provider Active NPI

Felicity L Mack, M.D.

  • Family Medicine Physician
  • Katy, TX
National Provider Identifier
1356662134
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P1564 Issued in TX
Practice address
460 Park Grove Dr
Katy, TX 77450-1571
Phone
(413) 862-2563
Fax
(203) 493-8028
NPI assigned
Jun 16, 2010
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Family Medicine Physician 207Q00000X P1564 TX Primary

Addresses

Primary practice location

460 Park Grove Dr
Katy, TX 77450-1571

Mailing address

460 Park Grove Dr
Katy, TX 77450-1571
Phone (413) 862-2563

Other identifiers 1

IdentifierTypeStateIssuer
4166548MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120706000606 TX Practitioner - Family Practice 1355506825 Reassigns benefits to 2 organizations
I20180301001078 NY Practitioner - Family Practice 1355506825 Practice locations: Buffalo, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balance Family Medicine, LLLPGroup PAC ID 6608093455, 3 clinicians

Practice addresses (Care Compare)

460 Park Grove Dr
Katy, TX 77450-1571
Phone (413) 862-2563

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rodom Medical Consulting PA Family Medicine CurrentSince May 31, 2012 Accepting new patients
Balance Family Medicine, PLLC Multi-Specialty CurrentSince Nov 20, 2013 Accepting new patients
Oakbend Medical Center Past Accepting new patients
Curahealth Houston Heights, LLC Past Accepting new patients

Locations

3101 S Austin Ave
Georgetown, TX 78626
Phone (512) 819-1100

1120 Cypress Station Dr
Houston, TX 77090
Phone (281) 893-7200

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

1917 Ashland St
Ste 300
Houston, TX 77008
Phone (713) 544-6814

2430 Fry Rd
Ste 100
Houston, TX 77084
Phone (281) 829-3999

460 Park Grove Dr
Katy, TX 77450
Phone (281) 206-7984

Organizations & group practices 4

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1356662134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 PARK GROVE DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501571",
            "telephone_number": "413-862-2563",
            "fax_number": "203-493-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PARK GROVE DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501571",
            "telephone_number": "413-862-2563",
            "fax_number": "203-493-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "FELICITY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4166548",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.