DR. SAMUEL ANDREW MACK MD
NPI 1902646094
Student in an Organized Health Care Education/Training Program in Tyler, TX
- Individual
- Male
- Student in an Organized Health Care Educ...
- PECOS Enrolled
About SAMUEL MACK
This page provides the complete NPI Profile along with additional information for Samuel Mack, a primary care provider established in Tyler, Texas with a medical specialization in Student In An Organized Health Care Education/training Program. The healthcare provider is registered in the NPI registry with number 1902646094 assigned on May 2024. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1902646094 Verify this NPI
- Provider Name
- DR. SAMUEL ANDREW MACK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1000 S BECKHAM AVE TYLER, TX 75701
- Location Phone
- (903) 597-0351
- Mailing Address
- 2740 ROYAL VILLAGE WAY TYLER, TX 75701
- Mailing Phone
- (903) 736-2047
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-28-2024
- Last Update Date
- 05-28-2024
- Code Navigator
A primary care provider (PCP) like Samuel Mack sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Student in an Organized Health Care Education/Training Program
- Taxonomy Code
- 390200000X
- Type
- Student, Health Care
- Taxonomy Description
- An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare Participation & PECOS Enrollment Status
Samuel Mack is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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Other Providers at the Same Location
The following 19 providers are registered at the same or a nearby location.
TYLER, TX 75701
TYLER, TX 75701
TYLER, TX 75701
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902646094, enumerated as an "individual" on May 28, 2024.
The provider is located at 1000 S BECKHAM AVE TYLER, TX 75701 and the phone number is (903) 597-0351.
Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
