KENNETH J MACK (M.D.) – Neurology with Special Qualifications in Child Neurology Physician, NPI 1689651044
Neurology with Special Qualifications in Child Neurology Physician
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Profile Insights
NPPES metrics only — not quality of care.
640 NEUROLOGY in MN
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Provider Addresses for KENNETH J MACK (M.D.)
1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States
ROCHESTER, MN 559050001
Phone: (507) 284-2511
Type: Location
600 HIGHLAND AVE
MADISON, WI 537920001
Phone: (608) 890-6500
Type: Location
7974 UW HEALTH CT
MIDDLETON, WI 535625531
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $35,568.
Total Amount is formed as General ($25,705) + Research ($9,863) + Ownership ($0) = $35,568.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($18,100).
Total Amount
$35,568
General + Research + Ownership
Payments
15
Total payment records
General Amount
$25,705
General payments
Research Amount
$9,863
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $18,100 |
| Eli Lilly and Company | $14,520 |
| PFIZER INC. | $2,235 |
| UPSHER-SMITH LABORATORIES LLC | $713 |
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: 2024-03-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20100308000580 | I | Neurology | MN | TBD |
| I20240329001789 | I | Neurology | WI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 9,300 | 50 | $0 |
| 64615 | Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face | 52 | 50 | $0 |
Insurance plans in this area (ZIP 55905)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| - | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| Family Practice | WI | |
| - | WI | |
| - | WI | |
| - | WI | |
| Endocrinology, Internal Medicine | WI | |
| Medical Oncology, Hematology/Oncology | CA |
Reviews
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