Dr James L Mack, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Bay Village, Ohio. His current practice location is
29017 Lincoln Rd, Bay Village, Ohio. You can reach out to his office (for appointments etc.) via phone at
(440) 899-1571.
Dr James L Mack is licensed to practice in Ohio (license number 1228) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659456903.
Healthcare Provider's Profile
| Full Name | Dr James L Mack |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 29017 Lincoln Rd, Bay Village, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1659456903
- Provider Enumeration Date: 10/26/2006
- Last Update Date: 01/04/2022
Medicare PECOS Information:
- PECOS PAC ID: 2567654940
- Enrollment ID: I20101004000708
Medical Identifiers
Medical identifiers for Dr James L Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659456903 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | P.1228 (Ohio) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 1228 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr James L Mack allows following entities to bill medicare on his behalf.
| Entity Name | University Hospitals Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669499414
PECOS PAC ID: 4789682493
Enrollment ID: O20061113000301 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr James L Mack is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr James L Mack, PHD
29017 Lincoln Rd,
Bay Village, OH 44140-1942
Ph: (440) 899-1571 | Dr James L Mack, PHD
29017 Lincoln Rd,
Bay Village, OH 44140-1942
Ph: (440) 899-1571 |
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