Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ANTHONY J MACK DO
NPI 1679268635
Emergency Medicine in Fairborn, OH

Q: 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.

Q: What is Anthony Mack's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: 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 10 days 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.

Active since April 06, 2023PECOS Enrolled

2555 UNIVERSITY DR, FAIRBORN, OH 45324(937) 775-8188 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 10, 2026, Apr 6, 2023 (2 updates tracked since 2023).

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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 Miami Valley Hospital, and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2023).

NPPES Registry Identity

NPI1679268635

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameANTHONY J MACKCredential: DO

Location Address2555 UNIVERSITY DRFairborn, OH 45324-6255

Mailing Address2555 University DrFairborn, OH 45324-6255 · (937) 775-8188

Phone(937) 775-8188

Sole ProprietorNo

Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2023

Enumeration DateApril 6, 2023

Last NPPES UpdateAugust 10, 20262 updates tracked since enumeration

NPPES CertifiedAugust 10, 2026

✔ NPI 1679268635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in IN · 02008872A

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2555 UNIVERSITY DR, Fairborn, OH 45324

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anthony J Mack Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840655239

PECOS Enrollment IDI20260612002535

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360051

LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County

Emergency services Birthing friendly

Physician 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.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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