Amy Mack, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11042282 Issued in FL

Practice address

822 Perkins St
Leesburg, FL 34748-4350

Phone

(352) 315-4111

Fax

(352) 315-4112

NPI assigned

Sep 25, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastroenterology and Nutrition of Central Florida LLCGroup PAC ID 8921000787, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Gastroenterology and Nutrition of Central Florida LLC

  • Gastroenterology Physician
  • Leesburg, FL
  • NPI 1316996945
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1518830587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 SE 174TH PLACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918984",
            "telephone_number": "352-245-7427",
            "fax_number": "352-245-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 PERKINS ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347484350",
            "telephone_number": "352-315-4111",
            "fax_number": "352-315-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "AMY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11042282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M & M Rehab., Inc.
• Francis Yuri Maccedo, MD
• Andrea M Macdonald, ARNP
• Macinnis Dermatology
• Colleen Renee Macinnis, MD
• Patricia Mack, BA
• Bonni Lynn Macqueen, APN
• Macrodont Solutions Inc
• Hope E Maddix, APRN
• Dino Madonna, M.D

• Gerontology Nurse Practitioner in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.