MR. TIMOTHY A MACK (APRN) – Family Nurse Practitioner, NPI 1104470590
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. TIMOTHY A MACK (APRN)
Shops Parkway, Bee Cave, Travis County, Texas, 78738, United States
BEE CAVE, TX 787386623
Phone: (512) 222-8667
Type: Mailing
11521 N FM 620 RD # SITE945
AUSTIN, TX 787261139
Phone: (512) 318-2559
Type: Mailing
11521 N FM 620 RD STE 945
AUSTIN, TX 787261115
Phone: (512) 318-2559
Type: Location
3725 N LAKELINE BLVD STE C
LEANDER, TX 786415354
Phone: (281) 783-8162
Type: Location
5718 WESTHEIMER RD STE 1800
HOUSTON, TX 770575773
Phone: (281) 783-8162
Type: Mailing
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: 2021-11-15
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 |
|---|---|---|---|---|
| I20211115002012 | I | Nurse Practitioner | TX | 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 78738)
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