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MRS. ALISHA NOEL MACK MSN
NPI 1710115654
Nurse Practitioner - Family in South Bend, IN

Active since June 30, 2009PECOS Enrolled
813 S MICHIGAN ST, SOUTH BEND, IN 46601(574) 283-5572(574) 283-5571 Get Directions Write a Review

NPPES record last updated: September 28, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Alisha Noel Mack Msn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ALISHA NOEL MACK MSN (NPI 1710115654) is an individual family provider in South Bend, Indiana, licensed in Indiana (28169564A) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710115654
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. ALISHA NOEL MACKCredential: MSN
Location Address813 S MICHIGAN STSouth Bend, IN 46601-3102
Mailing Address813 S Michigan StSouth Bend, IN 46601-3102 · (574) 283-5572
Phone(574) 283-5572
Fax(574) 283-5571
Sole ProprietorNo
Enumeration DateJune 30, 2009
Last NPPES UpdateSeptember 28, 2011
✔ NPI 1710115654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IN · 28169564A
813 S MICHIGAN ST, South Bend, IN 46601
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Other Identifiers 2

Medicare OSCAR/certification178420LLIN
Medicaid200962090IN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Alisha Noel Mack Msn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEACON MEDICAL GROUP, INC.
Family Medicine
813 S MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2400
MRS. VALERIA I VALTIERRA MSW
Social Worker (Clinical)
813 S MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 282-8700
INDIANA HEALTH CENTERS, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
813 S MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 235-7990
THE CENTER FOR THE HOMELESS, INC
Clinic/Center
813 S MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 282-8700

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 Alisha Mack's NPI number?

The NPI number for Alisha Mack is 1710115654. It was assigned to this individual provider in the NPPES registry on June 30, 2009.

Where is Alisha Mack located?

Alisha Mack practices at 813 S Michigan St, South Bend, IN 46601. The listed phone number is (574) 283-5572.

What is Alisha Mack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Alisha Mack enrolled in Medicare?

Yes. Alisha Mack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alisha Mack was last updated on September 28, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.