Nanaki Tisack

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

4351049150 Issued in MI

Practice address

3535 W 13 Mile Rd Ste 344
Royal Oak, MI 48073-6770

Phone

(248) 551-0497

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Associated Retinal Consultants, PC

  • Ophthalmology Physician
  • Royal Oak, MI
  • NPI 1215003793
  NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD (past)

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1124636378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 344",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISACK",
        "first_name": "NANAKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4351049150",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4351049150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James V Thorp, MD
• Patrick Daniel Thrasher, MD
• Thrive Speech and Language LLC
• Patrick Tierney, CRNA
• James Ting, MD
• Michael E Titus, OTRL
• Carlos Tobar, DO
• Donald Edward Tobianski
• Anne Marie Tobin, R.N.
• Michael Tocco, L.AC.

• Pulmonary Disease Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pulmonary Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.