ANTHONY J MACK DO
NPI 1679268635
Emergency Medicine in Fairborn, OH
About Anthony J Mack Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTHONY J MACK DO (NPI 1679268635) is an individual emergency medicine provider in Fairborn, Ohio, licensed in Indiana (02008872A) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent Hospital, and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2023).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Anthony J Mack Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Anthony Mack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Madison, IN 47250
- Reassigned Medicare billing, Indiana enrollment
- 598 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension St Vincent Hospital
Acute Care Hospitals · Indianapolis, INAscension St Vincent Anderson
Acute Care Hospitals · Anderson, INMiami Valley Hospital
Acute Care Hospitals · Dayton, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45324 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAIRBORN, OH 45324
FAIRBORN, OH 45324
FAIRBORN, OH 45324
FAIRBORN, OH 45324
FAIRBORN, OH 45324
FAIRBORN, OH 45324
FAIRBORN, OH 45324
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Anthony Mack's NPI number?
The NPI number for Anthony Mack is 1679268635. It was assigned to this individual provider in the NPPES registry on April 6, 2023.
Where is Anthony Mack located?
Anthony Mack practices at 2555 University Dr, Fairborn, OH 45324. The listed phone number is (937) 775-8188.
What is Anthony Mack's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Anthony Mack enrolled in Medicare?
Yes. Anthony Mack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Anthony Mack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Mack reassigns Medicare benefits to Cep America LLC (Madison, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anthony Mack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Anthony Mack affiliated with any hospitals?
According to CMS data, Anthony Mack is affiliated with Ascension St Vincent Hospital, Ascension St Vincent Anderson and Miami Valley Hospital.
When was this NPI record last updated?
The NPPES record for Anthony Mack was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Anthony J Mack, DO · NPI 1679268635
Emergency Medicine physician in Fairborn, Ohio. Individual provider, active in the CMS NPPES registry since April 6, 2023.
## Identity
- **NPI:** 1679268635 (Entity type: Individual)
- **Enumerated:** April 6, 2023
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 02008872A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 2555 UNIVERSITY DR, Fairborn, OH 45324-6255
- **Phone:** (937) 775-8188
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Cep America LLC (NPI 1720850233, Madison, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Kansas City University Of Med & Biosciences, College Of Osteo Med, class of 2023
## Record status
- **NPPES last updated:** August 10, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1679268635) · Data from the CMS NPPES public registry.