Individual provider Active NPI

Ivan Mac, MD

  • Ophthalmology Physician
  • Monroe, NC
National Provider Identifier
1689654592
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200401094 Issued in NC
Practice address
630 Comfort LN
Monroe, NC 28112-6199
Phone
(704) 289-5455
Fax
(704) 291-2207
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 200401094 NC Primary

Addresses

Primary practice location

630 Comfort LN
Monroe, NC 28112-6199

Mailing address

630 Comfort LN
Monroe, NC 28112-6199
Phone (704) 289-5455

Other identifiers 1

IdentifierTypeStateIssuer
89138MJMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041028000865 NC Practitioner - Ophthalmology 0749241834 Reassigns benefits to 1 organization
I20140905002497 SC Practitioner - Ophthalmology 0749241834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wake Forest University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metrolina Eye Associates PLLCGroup PAC ID 7315908498, 13 clinicians

Practice addresses (Care Compare)

630 Comfort Lane
Monroe, NC 28112-6199
Phone (704) 289-5455

724 Arden LN
Suite 120
Rock Hill, SC 29732-2995
Phone (803) 324-4258

Merit-based Incentive Payment System (MIPS)

Final score
95.15 of 100Reported as group
Quality
100
Improvement activities
40
Cost
83.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery458

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgery Center of the Carolinas, LLC Ophthalmology CurrentSince Feb 23, 2025 Accepting new patients
Metrolina Eye Associates, PLLC CurrentSince Sep 1, 2004 Accepting new patients
Metrolina Eye Associates, PLLC Ophthalmology CurrentSince Sep 1, 2004 Accepting new patients

Locations

2015 Randolph Rd
Ste 108
Charlotte, NC 28207
Phone (704) 334-2020

4101 Campus Ridge Rd
Matthews, NC 28105
Phone (704) 234-1930

4101 Campus Ridge Rd
Ste 200
Matthews, NC 28105
Phone (704) 234-1943

630 Comfort Ln
Ste E
Monroe, NC 28112
Phone (704) 289-5455

630 Comfort Ln
Monroe, NC 28112
Phone (704) 289-5455

6237 Carolina Commons Dr
Ste 300
Indian Land, SC 29707
Phone (803) 547-3937

1170 Edgewater Corporate Pkwy
Ste 106
Indian Land, SC 29707
Phone (803) 239-4504

724 Arden Ln
Ste 120
Rock Hill, SC 29732
Phone (803) 324-3070

Interoperability endpoints

  • Direct secure messaging: imac@metrolina.intellechartdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1689654592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 COMFORT LN",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126199",
            "telephone_number": "704-289-5455",
            "fax_number": "704-291-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 COMFORT LN",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126199",
            "telephone_number": "704-289-5455",
            "fax_number": "704-291-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200401094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138MJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.