Dr Gordon K Mack, MD - Medicare Pediatric Medicine in Boise, ID

Dr Gordon K Mack, MD is a medicare enrolled "Pediatrics - Pediatric Cardiology" physician in Boise, Idaho. He graduated from medical school in 1994 and has 30 years of diverse experience with area of expertise as Pediatric Medicine. He is a member of the group practice St Lukes Clinic-treasure Valley Llc and his current practice location is 100 E Idaho St, Suite 304, Boise, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 381-7384.

Dr Gordon K Mack is licensed to practice in Idaho (license number M-12151) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1982937058.

Contact Information

Dr Gordon K Mack, MD
100 E Idaho St, Suite 304,
Boise, ID 83712-6267
(208) 381-7384
(208) 381-7387



Physician's Profile

Full NameDr Gordon K Mack
GenderMale
SpecialityPediatric Medicine
Experience30 Years
Location100 E Idaho St, Boise, Idaho
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Gordon K Mack graduated from medical school in 1994
  NPI Data:
  • NPI Number: 1982937058
  • Provider Enumeration Date: 09/08/2009
  • Last Update Date: 02/05/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 2264570456
  • Enrollment ID: I20131119000649

Medical Identifiers

Medical identifiers for Dr Gordon K Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982937058NPI-NPPES
1982937058MedicaidID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2080P0202XPediatrics - Pediatric Cardiology 7320207-1205 (Utah)Secondary
2080P0202XPediatrics - Pediatric Cardiology M-12151 (Idaho)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St Lukes Clinic-treasure Valley Llc4981878402968

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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 Gordon K Mack allows following entities to bill medicare on his behalf.
Entity NameSt Lukes Clinic-treasure Valley Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326336058
PECOS PAC ID: 4981878402
Enrollment ID: O20111119000045

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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 Gordon K 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 AddressPractice Location Address
Dr Gordon K Mack, MD
190 E Bannock St,
Boise, ID 83712-6241

Ph: (208) 381-2222
Dr Gordon K Mack, MD
100 E Idaho St, Suite 304,
Boise, ID 83712-6267

Ph: (208) 381-7384

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Pediatrics Doctors in Boise, ID

Dr. Nathan D Meeker, M.D.
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 100 E Idaho St, Boise, ID 83712
Phone: 208-381-2782    Fax: 208-381-3172
Nicolas A Camilo, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 100 E Idaho St., Boise, ID 83712
Phone: 208-381-2782    Fax: 208-381-3172
Heather Carew, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 190 E Bannock St, Boise, ID 83712
Phone: 208-381-2645    
Dr. Frederick K Emge, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 100 E Idaho St, Suite 200, Boise, ID 83712
Phone: 208-381-7384    Fax: 208-381-7387
Annis Wakelee Vargas, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1072 N Liberty Street, Ste 203, Boise, ID 83701
Phone: 208-302-5800    Fax: 208-302-5855
Mrs. Lisa S Labor, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 8610 W Overland Rd, Boise, ID 83709
Phone: 208-954-8711    Fax: 208-375-2217
Mikelle E Mikesell, DO
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 8610 W Overland Rd, Boise, ID 83709
Phone: 208-954-8711    

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