David Alan Tack, M.D.
Individual provider Active NPI Dermatology Physician · Carson City, NV
NPI 1124032990 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124032990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 11209 (NV)
- Practice address
- 1100 S Carson St
Carson City, NV 89701-5232 - Phone
- (775) 883-7811
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- 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 PSC
Practice addresses (Care Compare)
1505 Medical Pkwy
Carson City, NV 89703-4634
Phone (775) 883-7811
Hospital & facility affiliations
- Carson Tahoe Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.72 of 100
- Quality
- 72.55
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 91.52
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 271 |
| Removal of skin lesions | 5299 |
| Removal of skin cancer | 727 |
| Removal or shaving of skin growth | 30 |
| Skin biopsy | 799 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050201000938 | NV | Practitioner - Dermatology | 4789677816 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clemmensen, Adams, & Tack PSC | Dermatology | Current |
Accepting new patients |
| Baptist Medical Center of the Beaches, Inc | Past | Accepting new patients | |
| Prime Healthcare Services - Reno LLC | Past | Accepting new patients | |
| David T Harvey MD PA | Past | Accepting new patients | |
| Mt Grant General Hospital | Past | Accepting new patients | |
| Sparks Family Hospital Inc | Past | Accepting new patients | |
| South Lyon Health Center, Inc. | Past | Accepting new patients |
Locations
1100 S Carson St
Carson City, NV 89701
Phone (775) 883-7811
1505 Medical Pkwy
Carson City, NV 89703
Phone (775) 883-7811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 11209 | NV | Yes |
Addresses
Primary practice location
1100 S Carson St
Carson City, NV 89701-5232
Mailing address
227 St Albans PL
Carson City, NV 89703-4546
Phone (775) 841-5259
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11209 | Other | NV | NV STATE MED. LIC # |
Other providers in Carson City, NV
- Kyle Edward Swanson
- Melissa Jane Swanson
- Skye Swanson
- Jade Swift
- Benjamin Syndergaard
- Pamela Taecker
- Tahoe Basin Home Healthcare
- Tahoe Carson Radiology Loos Et Al LTD
- Tahoe Facial Plastic Surgery PLLC
- Tahoe Fracture & Orthopedic Medical Clinic, Inc.
All providers in Carson City, NV · Dermatology Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.