Destiny L Mack

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

900 23Rd St NW
Washington, DC 20037-2342

Phone

(202) 715-4000

Fax

(202) 715-4015

NPI assigned

Oct 22, 2020

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 DC, MD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmack807259@direct.umm.edu

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.

• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, MD

  Medicare reassignment NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment
• Synergy Medical Group LLC

  • Internal Medicine Physician
  • Lutherville, MD
  • NPI 1912736901
  Medicare reassignment
• University of Maryland Physicians P.a.

  • Cardiovascular Disease Physician
  • Baltimore, MD
  • NPI 1689623175
  Medicare reassignment
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Laurel, MD
  • NPI 1831940881
  NPD
• Synergy Medical Group

  • Ophthalmology Physician
  • Timonium, MD
  • NPI 1447040852
  NPD
• Synergy Medical Group LLC

  • Nephrology Physician
  • Hagerstown, MD
  • NPI 1881564979
  NPD
• University of Maryland Physicians P.a.

  • Gastroenterology Physician
  • Largo, MD
  • NPI 1619860194
  NPD
• University of Maryland Physicians PA

  • Pulmonary Disease Physician
  • Baltimore, MD
  • NPI 1144270687
  NPD

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1629677398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 SHOREFIELD RD APT 122",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209021853",
            "telephone_number": "240-425-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000",
            "fax_number": "202-715-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DESTINY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Nicole Mack, LGPC
• Carol Jean Mack, P.A.-C
• Chakeena Renee Mack
• Charnetta Mack, HHA
• Daijah Mack
• Donesha Mack
• Ebony Mack
• Ebony Mack
• Ebony Mack, PSYD
• India Mack

• Medical Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Medical Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.