Gregory J Mack, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

651025 Issued in WI

Practice address

201 Cedar Falls Rd
Menomonie, WI 54751-1270

Phone

(715) 235-4274

Fax

(715) 235-9644

NPI assigned

Oct 4, 2006

Last updated

Jan 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

College of Podiatric Med and Surgery, Des Moines University, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foot and Ankle Clinic LLPGroup PAC ID 3971654021, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indianhead Medical Ctr Hospital, Shell Lake, WI, CCN 521342

Merit-based Incentive Payment System (MIPS)

Final score

96.79 of 100Reported as group

Quality

80.54

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

94.85 of 100Reported as group

Quality

89.04

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmack29636@oakleafmed.gardenplot.direct-ci.com
• Direct secure messaging: gmack95839@ewd.direct.hshs.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/gOP4994uTxKCP3l4vJ7Jqo6k1NZgHGsz/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foot and Ankle Clinic LLP

  • Foot & Ankle Surgery Podiatrist
  • Menomonie, WI
  • NPI 1144308321
  Medicare reassignment Care Compare group NPD

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

• Indianhead Medical Center Shell Lake, Inc

  • Critical Access Hospital
  • Shell Lake, WI
  • NPI 1568438125
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1760577506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547510392",
            "telephone_number": "715-235-4274",
            "fax_number": "715-235-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR FALLS RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547511270",
            "telephone_number": "715-235-4274",
            "fax_number": "715-235-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "651025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43214300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmack95839@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "201 Cedar Falls Rd",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547511270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hannah Kay Lunde, P.T.
• Amanda Kay Lustig, BS
• Dylan John Lynch, LAT, ATC
• Jason Martin Lynn, BSW
• Erin Mabry-Hilleshiem, LPC
• Morgan Mack, DPM
• Shauna Colleen Maloney, MS
• Taura Maraia, APNP
• Christopher Martinez, D.O.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc. (Mayo Clinic Health System-Menomonie)

• Foot & Ankle Surgery Podiatrist in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.