Active NPI
Rachel Mack, PA-C
- Physician Assistant
- Wheaton, MD
National Provider Identifier
1619522927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0007084
- Practice address
- 11406 Georgia Ave Ste F
Wheaton, MD 20902-1944 - Phone
- (301) 200-2230
- NPI assigned
- Aug 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0007084 | MD | Primary |
Addresses
Primary practice location
11406 Georgia Ave Ste F
Wheaton, MD 20902-1944
Mailing address
12754 Scaggsville Rd
Highland, MD 20777-9733
Phone (240) 678-3955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1050 Connecticut Ave NW
Suite 500
Washington, DC 20036-5304
Phone (202) 596-8891
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0007084 | MD | MD | Physician Assistant |
Interoperability endpoints
- rachel.mack.1@23388.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Washington, DC
- NPI 1245887959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564876800000",
"number": "1619522927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12754 SCAGGSVILLE RD",
"city": "HIGHLAND",
"state": "MD",
"postal_code": "207779733",
"telephone_number": "240-678-3955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11406 GEORGIA AVE STE F",
"city": "WHEATON",
"state": "MD",
"postal_code": "209021944",
"telephone_number": "301-200-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "RACHEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-04",
"last_updated": "2019-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0007084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2019; 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.