Aaron Tisack

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301518000 Issued in MI

Practice address

39450 W Twelve Mile Rd
Novi, MI 48377-3600

Phone

(248) 344-6688

NPI assigned

Mar 31, 2021

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

Not listed in the public Medicare enrollment file

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.

Specialty

Dermatology

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: atisack528716@direct.hfhs.org

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

• University of Texas Southwestern Medical Center at Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1285798918
  Care Compare affiliation

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1376121350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39450 W TWELVE MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773600",
            "telephone_number": "248-344-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISACK",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301518000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giancarla Tilea
• Shawntenique Tillis
• Timothy R Kirk OD PC
• Elizabeth Wilson Tindal, MD MPH
• Connie Tindall, MT
• Ryan Tisdall, DPT
• Shannon Titus
• Tlec Corp
• Juan Tobar
• Christina Todd

• Dermatology Physician in Novi, MI
• Providers in Novi, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.