Individual provider Active NPI

Mark E McCabe

  • Allergy & Immunology Physician
  • Tyler, TX
National Provider Identifier
1396107371
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
T0858 Issued in TX
Practice address
1128 Medical Dr
Tyler, TX 75701-2109
Phone
(903) 593-8273
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X T0858 TX Primary

Addresses

Primary practice location

1128 Medical Dr
Tyler, TX 75701-2109

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
1R6984OtherTXMEDICARE PTAN
1396107371MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002217 TX Practitioner - Allergy/Immunology 2860784576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners of Texas IncGroup PAC ID 0244486157, 22 clinicians

Practice addresses (Care Compare)

1128 Medical Dr
Tyler, TX 75701-2109
Phone (903) 593-8273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners of Texas, Inc Allergy & Immunology CurrentSince Sep 1, 2021 Accepting new patients
Allergy Partners of Texas, Inc Allergy & Immunology Current Accepting new patients
Allergy Partners of Texas, Inc. Allergy & Immunology CurrentSince Sep 1, 2021 Accepting new patients
Allergy Partners of Texas, Inc. Allergy & Immunology Past Accepting new patients

Locations

760 N Shiloh Rd
Garland, TX 75042
Phone (972) 272-4463

801 Medical Cir
Ste A
Longview, TX 75605
Phone (903) 593-8273

1128 Medical Dr
Tyler, TX 75701
Phone (903) 593-8273

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1396107371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012109",
            "telephone_number": "903-593-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "MARK",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "T0858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1R6984",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396107371",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.