Patrice C Mack, MD, PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME24010 Issued in FL

Practice address

801 Laurel Oak Dr Ste 715
Naples, FL 34108

Phone

(239) 254-0535

Fax

(239) 254-0532

NPI assigned

Apr 16, 2007

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 7, 2016 through Apr 7, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1558586388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 LAUREL OAK DR STE 715",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082754",
            "telephone_number": "239-254-0535",
            "fax_number": "239-254-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 LAUREL OAK DR STE 715",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34108",
            "telephone_number": "239-254-0535",
            "fax_number": "239-254-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "PATRICE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD, PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME24010",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME24010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J Macgeorge, LCSW
• Nikole Machovec
• Diana Maria Macian, M.D.
• James Joseph Maciejewski, M.D.
• Mary M Maciejewski, CRNA
• Josephine Meei Macken, DO
• Amy Mackenzie, R.D.N.
• Cynthia Anne Mackey, OT
• Laurette Mackinnon, D.C.
• Kathleen Margaret Macrina, O.D.

• Psychiatry Physician in Naples, FL
• Providers in Naples, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.