Johnathan Mack, M.D.

Primary specialty

Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X

License

267360 Issued in MA

Practice address

55 Fruit Street
Massachusetts General Hospital, Blood Bank, GRJ-238
Boston, MA 02114

Phone

(617) 726-3785

NPI assigned

May 27, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1972982650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL, BLOOD BANK, GRJ-238",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL, BLOOD BANK, GRJ-238",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JOHNATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MA",
            "license": "267360",
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MA",
            "license": "267360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernando Macias Martin, MD
• Laura Maciejko, MD
• Perla Michelle Macip Rodriguez, M.D.
• Darby Mack
• Jennifer Williams Mack, MD MPH
• Molly Mack, ACNPC-AG
• Christopher R Mackay
• Russell P Mackay
• Fiona Mackenzie, RN
• Jeremy Mackenzie

• Blood Banking & Transfusion Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Blood Banking & Transfusion Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.