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DR. ETHAN ANDREW MACK MD, PHD
NPI 1922627843
Pathology - Anatomic Pathology & Clinical Pathology in New York, NY

Active since April 10, 2020PECOS EnrolledAccepts Medicare Assignment
622 W 168TH ST PH 1564W, NEW YORK, NY 10032(212) 305-7399 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jun 4, 2026, May 22, 2025, Mar 10, 2025 and 1 more (4 updates tracked since 2020).

About Dr. Ethan Andrew Mack Md, Phd NPPES

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

DR. ETHAN ANDREW MACK MD, PHD (NPI 1922627843) is an individual anatomic pathology & clinical pathology provider in New York, New York, licensed in New York (334916) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with New York-presbyterian Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1922627843
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. ETHAN ANDREW MACKCredential: MD, PHD
Location Address622 W 168TH ST PH 1564WNew York, NY 10032-3720
Mailing Address180 Fort Washington AveNew York, NY 10032-3722
Phone(212) 305-7399
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 10, 2020
Last NPPES UpdateJune 4, 20264 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1922627843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in NY · 334916
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
622 W 168TH ST PH 1564W, New York, NY 10032
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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 and accepts Medicare assignment

Dr. Ethan Andrew Mack Md, Phd 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 ID345681201
PECOS Enrollment IDI20250501001902
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.

Areas of Expertise CMS Part B claims 2

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.

Blood bank physician services with written report 86079
A blood bank physician service involves a specialized doctor overseeing all aspects of blood collection, storage, and transfusion. They ensure the process is safe and effective. A written report details all procedures and findings for your reference and understanding.
39 services39 patients
Blood bank physician services for cross match and/or evaluation and written report 86077
Blood bank physician services for cross match involve testing your blood against donor blood to ensure compatibility before a transfusion. The evaluation includes a detailed analysis of your blood type and antibodies. A written report will be provided, summarizing the findings.
31 services30 patients

Hospital Affiliations CMS Care Compare

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

New York-Presbyterian Hospital

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330101
Location525 East 68th StreetNew York, NY 10065 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10032 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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.

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 Ethan Mack's NPI number?

The NPI number for Ethan Mack is 1922627843. It was assigned to this individual provider in the NPPES registry on April 10, 2020.

Where is Ethan Mack located?

Ethan Mack practices at 622 W 168th St Ph 1564W, New York, NY 10032. The listed phone number is (212) 305-7399.

What is Ethan Mack's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Ethan Mack enrolled in Medicare?

Yes. Ethan 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.

Is Ethan Mack affiliated with any hospitals?

According to CMS data, Ethan Mack is affiliated with New York-Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Ethan Mack was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.