DR. MATTHEW D MACK (NPI# 1770506958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770506958 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW D MACK |
| Credential | MD |
| Practice Address |
340 Arnett Blvd Rochester NY 14619-1147 |
| Mailing Address |
180 Mount Vernon Ave Rochester NY 14620-2344 |
| Practice Telephone | 5852352250 |
| Practice Fax Number | 5852350011 |
| Mailing Telephone | 5857473297 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 252075 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629289541 | Matthew P Mack | Dentist | 1420 Dickerson St, Newark, OH 43055-1844 | 2007-05-24 |
| 1205182094 | Matthew Miles Mack | Pharmacist | 3204 Peach Orchard Rd, Augusta, GA 30906-4862 | 2012-07-30 |
| Street Address |
340 ARNETT BLVD |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14619-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396735007 | William Raymond Morehouse | Family Medicine | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2005-10-24 |
| 1881015808 | Kristi Michelle Royko | Nurse Practitioner | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2013-12-17 |
| 1134477334 | His Branches, Inc. | Clinic/Center | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2012-08-17 |
| 1962757633 | Karen Elizabeth Dalton | Internal Medicine | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2012-07-19 |
| 1134485840 | His Branches, Inc. | Clinic/Center | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2012-04-06 |
| 1861770794 | Jessica Speares | Physician Assistant | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2011-07-26 |
| 1487844338 | Jennifer Lynn Celso | Physician Assistant | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2007-07-26 |
| 1508889783 | Nancy M Green | Family Medicine | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2006-07-26 |
| 1760421341 | Eric Alan Kerr | Physician Assistant | 340 Arnett Blvd, Rochester, NY 14619-1147 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558910430 | Cotton Blue Medical Transportation | Non-emergency Medical Transport (VAN) | 1035 Genesee Park Blvd, Rochester, NY 14619 | 2019-09-04 |
| 1700342714 | Shalom Transportation Services, Inc. | Non-emergency Medical Transport (VAN) | 84 Penhurst St, Rochester, NY 14619 | 2019-02-14 |
| 1639656689 | Dl Nursing Services | Licensed Practical Nurse | 116 Kingsboro Rd, Rochester, NY 14619 | 2018-07-23 |
| 1790206720 | Albert Tomlin Jr. | Driver | 121 Aberdeen St, Rochester, NY 14619 | 2017-06-29 |
| 1760915995 | Irie Transportation Associated | Taxi | 8-b Bradburn St, Rochester, NY 14619 | 2017-04-05 |
| 1902265366 | Trifena Browning | Licensed Practical Nurse | 167 Normandy Ave, Rochester, NY 14619 | 2016-02-15 |
| 1144663154 | Lehana Doctor | Social Worker | 107 Norris Drive, Suite D, Rochester, NY 14619 | 2013-04-09 |
| 1003190745 | Tanis Sharon Bridges | Registered Nurse | 261 Elmdorf Avenue, Rochester, NY 14619 | 2011-09-29 |
| 1386965853 | Pelecia Bordeaux | Licensed Practical Nurse | 340 Thurston Rd, Rochester, NY 14619 | 2010-06-18 |
| 1083933477 | Antoniece Keyonia-renee Poole | Licensed Practical Nurse | 77 Ringle St., Rochester, NY 14619 | 2010-05-25 |
| Find all providers in zip 14619 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881183028 | Silverstone Medical Group, Pllc | General Practice | 805 Oakwood Dr Ste 111, Rochester, MI 48307-1359 | 2018-05-03 |
| 1912422122 | Jan Andre Grauman Neander | General Practice | 57 Westmoreland Dr, Rochester, NY 14620-4533 | 2017-08-08 |
| 1639415284 | Wayne Lee Knochel | General Practice | 2004a Wolfs Point Dr, Rochester, IN 46975-7698 | 2012-12-28 |
| 1831469717 | Miroslav Kollar | General Practice | 1692 Maple Creek Court, Rochester, MI 48306-4812 | 2012-01-09 |
| 1316183247 | Ryan Paul Arnold | General Practice | 110 E Gunn Rd, Rochester, MI 48306-1801 | 2008-12-23 |
| 1285859306 | Sarah D Atkinson | General Practice | 885 Winton Rd S, Finger Lakes Clinical Research, Rochester, NY 14618-1609 | 2007-04-16 |
| 1548335722 | Gopiram M Pansari | General Practice | 519 Beahan Rd, Rochester, NY 14624-3403 | 2006-11-22 |
| 1598727992 | Cary S Feldman | General Practice | 811 Oakwood Dr, Suite 202, Rochester, MI 48307-1360 | 2006-04-03 |
| 1447757091 | Nancy Elizabeth Jordan | General Practice | 2110 E Center St, Rochester, MN 55904-4754 | 2018-04-10 |
| 1184166779 | Tamara Wilson Cisnero | General Practice | 82 Holland St, Rochester, NY 14605-2131 | 2016-11-14 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.