David Alan Tack, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

11209 Issued in NV

Practice address

1100 S Carson St
Carson City, NV 89701-5232

Phone

(775) 883-7811

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Nevada School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clemmensen, Adams, and Tack PSCGroup PAC ID 1052398591, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

Merit-based Incentive Payment System (MIPS)

Final score

88.72 of 100Reported as group

Quality

72.55

Promoting interoperability

98

Improvement activities

40

Cost

91.52

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clemmensen, Adams, & Tack PSC

  dba Carson Dermatology

  • Dermatology Physician
  • Carson City, NV
  • NPI 1780852368
  Medicare reassignment Care Compare group NPD Authorized official
• Mt Grant General Hospital

  • Critical Access Hospital
  • Hawthorne, NV
  • NPI 1801844527
  NPD (past)
• Prime Healthcare Services - Reno LLC

  dba Saint Mary's Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1801152566
  NPD (past)
• South Lyon Health Center, Inc.

  dba South Lyon Medical Center

  • Physical Therapist
  • Yerington, NV
  • NPI 1407815194
  NPD (past)
• Sparks Family Hospital Inc

  dba Northern Nevada Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1548250582
  NPD (past)
• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  NPD (past)
• David T Harvey MD PA

  dba Ponte Vedra Dermatology & Aesthetic Surgery

  • MOHS-Micrographic Surgery Physician
  • Ponte Vedra Beach, FL
  • NPI 1639198708
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124032990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 ST ALBANS PL",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034546",
            "telephone_number": "775-841-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S CARSON ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897015232",
            "telephone_number": "775-883-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACK",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "11209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Edward Swanson, MD
• Melissa Jane Swanson
• Skye Swanson
• Jade Swift, LMT
• Benjamin Syndergaard, D.M.D., M.S.
• Pamela Taecker, PTA
• Tahoe Basin Home Healthcare
• Tahoe Carson Radiology Loos Et Al LTD (Tahoe Carson Radiology)
• Tahoe Facial Plastic Surgery PLLC (Tahoe Facial Plastic Surgery)
• Tahoe Fracture & Orthopedic Medical Clinic, Inc.

• Dermatology Physician in Carson City, NV
• Providers in Carson City, NV by specialty
• Dermatology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.