NPIMap

Individual provider Active NPI

Jason D Mack, DO

  • Family Medicine Physician
  • Wausau, WI
National Provider Identifier
1609169200
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60327 Issued in WI
Practice address
425 Wind Ridge Dr
Wausau, WI 54401-4149
Phone
(715) 675-3391
Fax
(715) 675-5255
NPI assigned
May 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 60327 WI Primary

Addresses

Primary practice location

425 Wind Ridge Dr
Wausau, WI 54401-4149

Mailing address

425 Wind Ridge Dr
Wausau, WI 54401-4149
Phone (715) 675-3391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807002569 WI Practitioner - Family Practice 7214154608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

333 Pine Ridge Blvd
Wausau, WI 54401-4102

333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone (715) 847-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60327WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. Family Medicine CurrentSince Dec 30, 2021 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Dec 30, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 1, 2014 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

425 Wind Ridge Dr
Wausau, WI 54401
Phone (715) 675-3391

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1609169200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WIND RIDGE DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014149",
            "telephone_number": "715-675-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WIND RIDGE DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014149",
            "telephone_number": "715-675-3391",
            "fax_number": "715-675-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "60327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.