BROWNELL III MACK (PSYD) – Psychologist, NPI 1023095627

BROWNELL III MACK (PSYD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in Psychologist. They hold the professional credentials PSYD. They hold a License No. LP4548 (MN). The NPI Number for BROWNELL III MACK (PSYD) is 1023095627

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
BROWNELL III MACK (PSYD)
NPI
1023095627
Phone
(612) 302-4600
Address
1313 PENN AVE N
Enumeration Date
27 December 2005
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6129256033
Graduation Year
2002 (24 years ago)
PAC ID
3274557277
Group Practice PAC ID
0749171320
Professional Enrollment ID
I20060117001091
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for BROWNELL III MACK (PSYD)

  • Northpoint Health & Wellness Center, 1313, Penn Avenue North, Bryn Mawr, Minneapolis, Hennepin County, Minnesota, 55411, United States

    MINNEAPOLIS, MN 554113047

    Phone: (612) 302-4600

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2006-01-17

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060117001091IClinical PsychologistMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 55411)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749171320View full group profile

Reviews

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Frequently asked questions

Is there an official ID for BROWNELL III MACK (PSYD) in U.S. healthcare records?
The official identifier for BROWNELL III MACK (PSYD) is NPI 1023095627.
Is BROWNELL III MACK (PSYD) shown as active in public data?
Registry records indicate BROWNELL III MACK (PSYD) maintains an active NPI.
What clinical focus is listed for BROWNELL III MACK (PSYD)?
At a glance, BROWNELL III MACK (PSYD) is tied to Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with BROWNELL III MACK (PSYD)?
Directory geography for BROWNELL III MACK (PSYD) centers on Minneapolis, Minnesota.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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