Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Gordon K Mack, MD

Individual provider Pediatric Cardiology Physician · NPI 1982937058

Dr. Gordon K Mack, MD is a Pediatric Medicine in Boise, Idaho. Qualified in 1994, 32 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho and Utah.

Years since qualifying
32
Licensed in
ID, UT
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 E Idaho St Ste 304
Boise, ID 83712-6267
Phone: (208) 381-7384
Fax: (208) 381-7387
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Cardiology Physician (primary) Taxonomy 2080P0202X · Licence M-12151 (ID)
Pediatric Cardiology Physician Taxonomy 2080P0202X · Licence 7320207-1205 (UT)

Record details

NPI number1982937058
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 8, 2009
Last updated in NPPESFebruary 5, 2014
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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