Active NPI 1932125184 Individual Practitioner Female Practitioner

Dr. Annie Seapan Mack , MD

Pediatrics • Portland, OR

✓ Accepts Medicare Assignment Telehealth Available

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Annie Mack, MD is a registered Pediatrics practitioner in Portland, OR. With approximately 25 years of clinical practice since graduating from University Of Texas Medical School At San Antonio in 2001, Dr. Mack provides healthcare services at the registered practice location at 9555 SW BARNES RD STE 255.

Dr. Mack is affiliated with Advanced Internal Medicine Group Pc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, insertion of needle into vein for collection of blood sample, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

9555 Sw Barnes Rd Ste 255

Portland, OR 972256654

Telephone 5039081590

Fax 5037232862

Associated Practice Facility / Clinic

🏢 Advanced Internal Medicine Group, Pc Facility NPI 1487014163

Medicare Profile & Education

Medical School

University Of Texas Medical School At San Antonio

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Portland, OR

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs +9.5 yrs vs City Avg

City Avg: 15.5 Yrs

State Avg: 20.9 Yrs

Regional Practice Density

282 Specialists

Practicing in Portland, OR (880 Statewide)

Telehealth Adoption Rate

0.7% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

54.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mack (25 Years) 25 Yrs

Portland Specialty Average (15.5 Years) 15.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	155	87	$424.06	$181.43
36415 Insertion of needle into vein for collection of blood sample	69	48	$12.00	$8.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	64	53	$324.07	$131.56
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	41	41	$185.49	$132.97
99213 Established patient office or other outpatient visit, typically 15 minutes	40	34	$234.63	$93.30
G0008 Administration of influenza virus vaccine	34	34	$75.00	$33.23
90653 Vaccine for influenza for injection into muscle	32	32	$115.00	$81.82
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$584.64	$223.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	137	70	$424.06	$176.93
36415 Insertion of needle into vein for collection of blood sample	82	54	$12.00	$8.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	57	$324.07	$121.00
99213 Established patient office or other outpatient visit, typically 15 minutes	60	54	$234.63	$82.92
G0008 Administration of influenza virus vaccine	29	28	$45.00	$31.47
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	27	27	$99.07	$75.72
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	26	26	$185.49	$132.08
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	26	26	$584.64	$223.49
93000 Routine ekg using at least 12 leads including interpretation and report	12	11	$32.03	$14.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	93	55	$424.49	$175.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	36	$324.07	$120.18
36415 Insertion of needle into vein for collection of blood sample	38	31	$12.00	$2.95
G0008 Administration of influenza virus vaccine	31	31	$45.00	$30.59
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	30	30	$75.00	$70.25
99213 Established patient office or other outpatient visit, typically 15 minutes	26	25	$234.63	$76.24
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	18	18	$584.64	$224.75
99442 Telephone medical discussion with physician, 11-20 minutes	17	16	$93.71	$64.67
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	12	12	$185.49	$133.67
0134A Fee covid-19 vac 14 res	12	12	$40.00	$39.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	40	$346.00	$112.85
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	19	17	$464.00	$149.85
99213 Established patient office or other outpatient visit, typically 15 minutes	13	11	$238.00	$71.55
36415 Insertion of needle into vein for collection of blood sample	11	11	$21.00	$2.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	52	$463.00	$147.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	88	58	$346.00	$108.43
36415 Insertion of needle into vein for collection of blood sample	36	28	$21.00	$2.80
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	21	18	$27.00	$8.57
99213 Established patient office or other outpatient visit, typically 15 minutes	19	18	$236.00	$66.11
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	16	16	$30.00	$18.65
G0008 Administration of influenza virus vaccine	16	16	$30.00	$17.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	86	55	$344.00	$107.47
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	70	45	$463.00	$144.81
36415 Insertion of needle into vein for collection of blood sample	41	27	$21.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	24	20	$233.00	$73.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	120	56	$342.00	$107.46
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	67	31	$461.00	$146.51
36415 Insertion of needle into vein for collection of blood sample	38	26	$21.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	22	19	$233.00	$72.35
G0008 Administration of influenza virus vaccine	20	20	$30.00	$26.27
90662 Influenza vaccine split virus, preservative free	15	15	$30.00	$27.44
G0009 Administration of pneumococcal vaccine	11	11	$81.00	$26.27

Medical Specialties & State Licenses

CMS Verified: 2024-03-01

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OR MD27041

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License OR MD27041

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

500633407 (OR)

Hospital & Practice Group Affiliations

Advanced Internal Medicine Group Pc

9555 Sw Barnes Rd, Portland, OR 972256654

Phone: 5039081590

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Aoife O'sullivan , MD

Family Medicine

NPI 1073657003

Doctor of Medicine (M.D.)

Dr. Thomas Gragnola , MD

Internal Medicine

NPI 1144220765

Doctor of Medicine (M.D.)

Dr. Amy Gillcrist , MD

Internal Medicine

NPI 1952347528

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location April 03, 2024

Registered at 9555 SW BARNES RD STE 255, PORTLAND, OR 972256654 (Tel: 5039081590)

📍

Updated Practice Location July 14, 2021

Registered at 9800 SE SUNNYSIDE RD, CLACKAMAS, OR 970159750 (Tel: 8008132000)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2021

Internal Medicine (License #MD27041 in OR)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 06, 2020

Pediatrics (License #MD27041 in OR)

✅

NPI Profile Active January 10, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location January 10, 2013

Registered at 5050 NE HOYT ST, SUITE 454, PORTLAND, OR 972132984 (Tel: 5032156405)

📍

Updated Business Mailing Address January 10, 2013

Registered at PO BOX 3158, PORTLAND, OR 972083158 (Tel: 5032156494)

👤

Provider Name / Credentials Updated January 10, 2013

Recorded as ANNIE MACK, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 10, 2013

Internal Medicine (License #MD27041 in OR)

🟢

Initial NPI Registration & Enumeration July 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932125184

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 14, 2006

Last Update: April 03, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 3158

Portland, OR 972083158

Phone: 5032156494

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.