Doctor profile · Federal record
Dr. KELLY MACK, PA-C
Medical Physician Assistant (CMS: PHYSICIAN ASSISTANT) · Medical Physician Assistant · PRINCE FREDERICK, MD
- NPI 1396813960
- Accepts Medicare
- MIPS 95.8 / 100 · 2023
- 21 yrs in practice
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
995 N. PRINCE FREDERICK BLVD, SUITE 204
PRINCE FREDERICK, MD 20678
(410) 535-5855
fax (410) 535-6574 - Mailing address
-
4505 KINGWOOD DR, STE 185
KINGWOOD, TX 773452618
Credentials & registration
- NPI registered
- December 2006 — 20 yrs on file
- Profile last updated
- August 13, 2019
- Year of graduation
- 2005 — 21 yrs since
- Specialty taxonomy
- 363AM0700X — NUCC code
- State licenses (2)
- Texas #PA07662 · California #PA18061
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1396813960. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
877
Distinct HCPCS
10
Medicare allowed
$44,064
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
17003 |
Destruction of precancer skin growth, 2-14 growths | 348 | 56 | $6 | |
17000 |
Destruction of precancer skin growth, 1 growth | 107 | 76 | $42 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 107 | 83 | $78 | |
17110 |
Destruction of skin growth, 1-14 growths | 86 | 76 | $97 | |
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 75 | 63 | $110 | |
11102 |
Biopsy of related skin growth, first growth | 66 | 56 | $76 | |
99212 |
Established patient office or other outpatient visit, 10-19 minutes | 28 | 25 | $49 | |
99203 |
New patient office or other outpatient visit, 30-44 minutes | 23 | 23 | $97 | |
99204 |
New patient office or other outpatient visit, 45-59 minutes | 21 | 21 | $142 | |
99202 |
New patient office or other outpatient visit, 15-29 minutes | 16 | 16 | $63 |
In context: peer comparison
Among 2 peers in this city , average services per provider: 113. This provider delivers 7.8× the peer median.Open Payments
Industry payments received
All-time total
$3,683
Transactions
176
Manufacturers
15
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| SUN PHARMACEUTICAL INDUSTRIES INC. | 20 | $548.47 | |
| Janssen Biotech, Inc. | 13 | $381.97 | |
| Lilly USA, LLC | 17 | $373.33 | |
| Regeneron Healthcare Solutions, Inc. | 9 | $294.25 | |
| LEO Pharma Inc. | 21 | $281.87 | |
| Incyte Corporation | 13 | $255.60 | |
| GENZYME CORPORATION | 9 | $247.16 | |
| Novartis Pharmaceuticals Corporation | 13 | $235.20 | |
| Amgen Inc. | 11 | $212.34 | |
| ABBVIE INC. | 13 | $198.67 | |
| E.R. Squibb & Sons, L.L.C. | 15 | $168.77 | |
| Dermavant Sciences, Inc. | 5 | $121.45 | |
| Arcutis Biotherapeutics, Inc. | 5 | $92.25 | |
| Ortho Dermatologics, a division of Bausch Health US, LLC | 4 | $68.21 | |
| MAYNE PHARMA COMMERCIAL LLC | 8 | $50.09 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
249
Patients
163
Total drug cost
$6,609
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Triamcinolone Acetonide | Generic | 51 | 36 | $448 |
| Mupirocin | Generic | 42 | 37 | $402 |
| Ketoconazole | Generic | 33 | 20 | $418 |
| Clobetasol Propionate | Generic | 31 | 23 | $2,599 |
| Hydrocortisone | Generic | 22 | 20 | $159 |
| Clindamycin Phosphate | Generic | 21 | 16 | $939 |
| Fluorouracil | Generic | 14 | 11 | $1,263 |
| Minoxidil | Generic | 12 | 0 | $133 |
| Nystatin | Generic | 12 | 0 | $142 |
| Valacyclovir (Valacyclovir Hcl) | Brand | 11 | 0 | $106 |