Individual provider Active NPI

Deborah Lynn Mack, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1407813744
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
01051109A Issued in IN
Practice address
8111 S Emerson Ave FL 5
Indianapolis, IN 46237-8601
Phone
(317) 528-8930
Fax
(317) 528-8932
NPI assigned
Apr 28, 2006
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01051109A IN
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 01051109A IN Primary

Addresses

Primary practice location

8111 S Emerson Ave FL 5
Indianapolis, IN 46237-8601

Mailing address

PO Box 781076
Detroit, MI 48278-1008
Phone (317) 528-4800

Other practice location 1

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 278-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250506003597 IN Order and Referring Only - Hospice/Palliative CarePractitioner - Hospice/Palliative Care 9133646847

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

236 Evergreen Dr
Batesville, IN 47006-5161

PO Box
Suite 781076
Detroit, MI 48278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051109AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1407813744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781008",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE FL 5",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601",
            "telephone_number": "317-528-8930",
            "fax_number": "317-528-8932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-278-5316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01051109A",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "IN",
            "license": "01051109A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.