Michael Mak IV, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

01068313A Issued in IN

Practice address

2400 17TH St
Columbus, IN 47201-5351

Phone

(812) 378-2980

Fax

(812) 378-2982

NPI assigned

Oct 11, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bensonhurst Mega Medical Care PC

  • Adolescent Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1871747006
  NPD (past) Authorized official
• Columbus Urgent Care Center

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1548338635
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• A.K. Podiatrist D.P.M. P.C.

  • Foot Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1326182478
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1811085129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 19TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021310",
            "telephone_number": "317-924-4022",
            "fax_number": "317-924-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-378-2980",
            "fax_number": "812-378-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01068313A",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "211790",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (NY)",
            "identifier": "05679M",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200991920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathon Mack, RBT
• Mary Cathleen Academia Madanguit, RPT
• Mallory Maguire
• Kristain Mails
• McKenna Major
• Mary Mallay, MSW,LCSW, LCAC
• Tyrone Christopher A. Manalac, M.D.
• Natale Manes
• Megan Clemens Mangas, RN, CRNA
• Michael Drach Mangas, O.D.

• Hematology & Oncology Physician in Columbus, IN
• Providers in Columbus, IN by specialty
• Hematology & Oncology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.