Martha Anne Tack, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11149 Issued in MN

Practice address

1804 Trott Ave SW
Willmar, MN 56201-2743

Phone

(320) 214-7286

NPI assigned

Dec 29, 2023

Sex

Female

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of North Dakota School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecumen Home Care and Hospice - Litchfield Home health agency, Litchfield, MN, CCN 247217
• Centracare Hospice Hospice, Willmar, MN, CCN 241509
• Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088
• Hutchinson Health Hospital, Hutchinson, MN, CCN 240187

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

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 and National Provider Directory roles.

• Twin Cities Physicians Professional Corporation

  • Multi-Specialty Clinic/Center
  • Golden Valley, MN
  • NPI 1992176499
  Medicare reassignment Care Compare group NPD

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

• Carris Health LLC

  dba CentraCare - Rice Memorial Hospital

  • Infusion Therapy Clinic/Center
  • Willmar, MN
  • NPI 1124657150

  Hospital

  Care Compare affiliation
• Carris Health LLC

  dba CentraCare Hospice

  • Community Based Hospice Care Agency
  • Willmar, MN
  • NPI 1306359856
  Care Compare affiliation
• Carris Health LLC

  dba CentraCare - Rice Memorial Hospital

  • General Acute Care Hospital
  • Willmar, MN
  • NPI 1407367030
  Care Compare affiliation
• Ecumen

  dba Ecumen Home Care - Litchfield

  • Home Health Agency
  • Litchfield, MN
  • NPI 1497821425
  Care Compare affiliation
• Hutchinson Health

  dba Hutchinson Health Hospital

  • General Acute Care Hospital
  • Hutchinson, MN
  • NPI 1053508820
  Care Compare affiliation

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1346019445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 TROTT AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012743",
            "telephone_number": "320-214-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 TROTT AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012743",
            "telephone_number": "320-214-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACK",
        "first_name": "MARTHA",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Sweney
• Carla Lee Swenhaugen, LPCC
• Molly Em Swenson, LMFT
• Kathleen Elizabeth Lippert Swystun, DC
• Tanner John Swystun, DC
• Sarah Tanner, OTR
• Kelly Taunton
• Karen Denese Taylor-Crawford, MD
• Aimee Lyn Tebrake, CNS
• Technical Academies of Minnesota

• Family Nurse Practitioner in Willmar, MN
• Providers in Willmar, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.