Mack J Rachal, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036853 Issued in GA

Practice address

1110 W Peachtree St NW Ste 1040
Atlanta, GA 30309

Phone

(404) 888-5050

Fax

(404) 688-8883

NPI assigned

May 10, 2006

Last updated

Apr 26, 2021By 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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA, TX2 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

Specialty

Dermatology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hill Country Memorial Hospital Hospital, Fredericksburg, TX, CCN 450604
• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

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: mack.rachal@northsidehospital.cernerdirect.com
• Direct secure messaging: mrachal@conger.emadirect.md

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.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Georgia Surgical Professional Services, LLC

  • Otolaryngology Physician
  • Atlanta, GA
  • NPI 1801224506
  NPD (past)
• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  NPD (past)

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

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Methodist Hospital Hill Country

  • General Acute Care Hospital
  • Fredericksburg, TX
  • NPI 1376256354
  Care Compare affiliation
• Sid Peterson Memorial Hospital

  dba Peterson Regional Medical Center

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1902856370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "SUITE 1230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082238",
            "telephone_number": "404-215-6520",
            "fax_number": "404-688-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PEACHTREE ST NW STE 1040",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-888-5050",
            "fax_number": "404-688-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHAL",
        "first_name": "MACK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "036853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MMA@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1110 W Peachtree St NW Ste 1040",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mack.rachal@northsidehospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1110 W Peachtree St NW Ste 1040",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marina Rabinovich, PHARM.D.
• Paul S Rabinowitz, M.D.
• Yaakov A Rabinowitz, LCSW
• Cynthia Michele Race, ATC
• Funmilayo Carter Rachal, M.D.
• Rachel Brandeis Registered Dietitian LLC
• Pratik Vasant Rachh, MD, MBA
• Katherine Anne Raciborski, CT (ASCP)
• Rad X USA LLC
• Ava Tompkins Radakovich, PA-C

• Dermatology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.
• 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.