Emilie A Tack, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

246375 Issued in MA

Practice address

830 Oak St Ste 124E
Brockton, MA 02301-1192

Phone

(508) 897-4730

NPI assigned

Dec 11, 2007

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

Other names 1

• Dr. Emilie Fisher Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Obstetrics/Gynecology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: etack259776@direct.bmc.masshiway.net
• Direct secure messaging: emilie.tack.1@2017.direct.athenahealth.com

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.

• BMC Affiliated Physicians, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1245320910

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Mass General Brigham Medical Group Suburban Massachusetts Inc

  • Family Medicine Physician
  • Newton, MA
  • NPI 1538191218
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1114265634
  NPD
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Norwood, MA
  • NPI 1467847632

  Obstetrics & Gynecology

  NPD
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914

  Obstetrics & Gynecology

  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Boston Medical Center - South Corporation

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  NPD (past)

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

• Boston Medical Center - South Corporation

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  Care Compare affiliation

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1235312448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-4505",
            "fax_number": "781-255-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OAK ST STE 124E",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011192",
            "telephone_number": "508-897-4730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1177 Providence Highway",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "02062",
            "country_code": "US",
            "telephone_number": "781-278-5575",
            "fax_number": "781-255-0774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACK",
        "first_name": "EMILIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101017260",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "246375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "etackdo179956@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "1177 Providence Highway",
            "city": "Norwood",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILIE",
            "last_name": "FISHER",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Sypek
• Elizabeth Syring
• Andrew Szumita, PHARMD
• T.Chang , DMD P.C.
• Edward Tabasky
• Ashley Elizabeth Tagrin
• Dil Tahera, M.D.
• Syed M Tahir, MD
• Tailored Health LLC
• Charnya Vivian Tajah- Dennis

• Obstetrics & Gynecology Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• 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.