WILLIAM JACOB MACK IV M.D.
NPI 1811163793
Neurological Surgery in Los Angeles, CA

Q: What is William Mack's NPI number?

The NPI number for William Mack is 1811163793. It was assigned to this individual provider in the NPPES registry on May 1, 2008.

Q: What is William Mack's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Q: When was this NPI record last updated?

The NPPES record for William Mack was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 May 01, 2008PECOS EnrolledAccepts Medicare Assignment

1520 SAN PABLO ST STE 3800, LOS ANGELES, CA 90033(323) 442-5720 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 25, 2020, Feb 5, 2019, Jan 25, 2019 (3 updates tracked since 2019).

On this page

About William Jacob Mack Iv M.d. NPPES

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

WILLIAM JACOB MACK IV M.D. (NPI 1811163793) is an individual neurological surgery provider in Los Angeles, California, licensed in California (A104088) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Physicians And Surgeons (2001).

NPPES Registry Identity

NPI1811163793

Entity TypeIndividualMale

Primary Taxonomy207T00000X

Provider Legal NameWILLIAM JACOB MACK IVCredential: M.D.

Location Address1520 SAN PABLO ST STE 3800Los Angeles, CA 90033-5328

Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (323) 442-5720

Phone(323) 442-5720

Sole ProprietorNo

Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 2001

Enumeration DateMay 1, 2008

Last NPPES UpdateNovember 27, 20233 updates tracked since enumeration

NPPES CertifiedAugust 25, 2020

✔ NPI 1811163793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207T00000X

License✔ Licensed in CA · A104088

Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

1520 SAN PABLO ST STE 3800, Los Angeles, CA 90033

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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

William Jacob Mack Iv M.d. 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.

PECOS PAC ID3577636083

PECOS Enrollment IDI20080716000645

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.

Medicare Billing Reassignment

Medicare enrollment records show William Mack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Usc Care Medical Group, Inc

Same address

General Practice

1520 SAN PABLO ST
Los Angeles, CA 90033

Reassigned Medicare billing, California enrollment
2,445 clinicians in this Medicare group

NPI 1902846306 (323) 442-5955

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist 36224

This procedure involves placing a small tube into your neck artery. It helps diagnose or treat certain conditions. A radiologist, a doctor specializing in medical imaging, reviews the process to ensure accuracy and safety.

22 services22 patients

Imaging of blood vessel 75898

Imaging of blood vessels, also known as vascular imaging, is a non-invasive procedure that allows doctors to view the condition of your blood vessels. It employs techniques like ultrasound, CT scan, or MRI to capture images, enabling the detection of blockages or abnormalities.

22 services14 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

20 services19 patients

Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist 36227

This procedure involves placing a small tube into an artery in your neck. This is done to diagnose or treat certain conditions. A radiologist, a doctor who specializes in medical imaging, will review the procedure to ensure everything is done correctly.

17 services17 patients

Insertion of tube into brain artery for diagnosis or treatment with review by radiologist 36226

This procedure involves inserting a thin tube into a brain artery. It aids in diagnosing or treating brain conditions. A radiologist reviews the process to ensure accuracy and safety. It's a critical step in managing brain health effectively.

15 services15 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90033 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

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.

JONATHAN SISTI MD

Neurological Surgery