DR. GORDON K MACK (MD) – Pediatric Cardiology Physician, NPI 1982937058
Pediatric Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. GORDON K MACK (MD)
St. Luke's Boise Medical Center, 190, East Bannock Street, Downtown, Boise, Ada County, Idaho, 83712, United States
BOISE, ID 837126241
Phone: (208) 381-2222
Type: Mailing
100, East Idaho Street, Downtown, Boise, Ada County, Idaho, 83712, United States
SUITE 304
BOISE, ID 837126267
Phone: (208) 381-7384
Fax: (208) 381-7387
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $53.
Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.
Last reported payment date: 2024-11-15 • Largest payer in this snapshot: iRhythm Technologies, Inc. ($30).
Total Amount
$53
General + Research + Ownership
Payments
2
Total payment records
General Amount
$53
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| iRhythm Technologies, Inc. | $30 |
| Abbott Laboratories | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-11-19
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131119000649 | I | Pediatric Medicine | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83712)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | ME | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | TX | |
| - | OR | |
| Hand Surgery | ID | |
| - | ID | |
| Nurse Practitioner | ID | |
| General Surgery | ID | |
| Cardiovascular Disease (Cardiology), Cardiac Electrophysiology, Internal Medicine | ID |
Reviews
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