William P Mack, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

ME65603 Issued in FL

Practice address

3109 W. Azeele Street
Tampa, FL 33609

Phone

(813) 875-5437

Fax

(813) 873-9373

NPI assigned

Jul 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of South Florida College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William Mack M D P aGroup PAC ID 6305865924, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.42 of 100Reported as individual

Quality

66.22

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.mack@direct.moffitt.org
• Direct secure messaging: william.mack.1@29751.direct.athenahealth.com

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.

• William Mack M D P a

  • Ophthalmology Physician
  • Tampa, FL
  • NPI 1669682399
  Medicare reassignment Care Compare group NPD Authorized official
• H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

  • Hematology & Oncology Physician
  • Tampa, FL
  • NPI 1306833595
  NPD
• The Eye Physicians of Pinellas, PA

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1114925153
  NPD (past)
• The Eye Physicians of Pinellas, PA

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1679570816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 W. AZEELE STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-875-5437",
            "fax_number": "813-873-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 W. AZEELE STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-875-5437",
            "fax_number": "813-873-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME65603",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME65603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2074423",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250029900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5204189",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6012101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA",
            "identifier": "31233",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0805198",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick R Maciver, MD
• Brandon Tramell Mack, D.D.S.
• Evelyn Gil Mack, CTRS
• Naomi Elizabeth Mack
• Sean Adam Mack, PA-C
• Kayla C Mackanin, BS
• Grace Mackay
• Kathryn Leigh Mackenzie, LCSW
• David Warren Mackey, M.S.W., L.C.S.W.
• Benjamin Dann Mackie, M.D.

• Ophthalmic Plastic and Reconstructive Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.