DOUGLAS TIMOTHY MACK (MD) – Otolaryngology Physician, NPI 1861993552
Otolaryngology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DOUGLAS TIMOTHY MACK (MD)
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 782344504
Phone: (210) 916-3910
Fax: (210) 916-2077
Type: Mailing
400 E 3rd St
Duluth, MN 558051951
Phone: (218) 786-8364
Type: Location
4076 NEELY ROAD
FORT WAINWRIGHT, TX 99703
Phone: (907) 361-5172
Type: Mailing
4076 NEELY RD.
APO, AA 99703
Phone: (907) 361-5172
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $254.
Total Amount is formed as General ($254) + Research ($0) + Ownership ($0) = $254.
Last reported payment date: 2024-10-16 • Largest payer in this snapshot: Inspire Medical Systems, Inc. ($254).
Total Amount
$254
General + Research + Ownership
Payments
3
Total payment records
General Amount
$254
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inspire Medical Systems, Inc. | $254 |
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: 2025-02-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250227001845 | I | Otolaryngology | MN | 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 78234)
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Reviews
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