Individual provider Active NPI

Marc Tack, DO

  • Infectious Disease Physician
  • Kingston, NY
National Provider Identifier
1376582015
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
191978 Issued in NY
Practice address
360 Washington Ave
Kingston, NY 12401-3702
Phone
(845) 338-7140
Fax
(845) 338-7141
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 191978 NY Primary

Addresses

Primary practice location

360 Washington Ave
Kingston, NY 12401-3702

Mailing address

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20070405000201 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 0648374397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of the Hudson ValleyGroup PAC ID 2860384674, 24 clinicians

Practice addresses (Care Compare)

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Hospital & facility affiliations

  • Archcare at Home Home health agency, Valhalla, NY, CCN 337140
  • Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
  • Margaretville Memorial Hospital Hospital, Margaretville, NY, CCN 331304

Merit-based Incentive Payment System (MIPS)

Final score
23.82 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
79.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
191978NYMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of the Hudson Valley Infectious Disease CurrentSince Aug 4, 1996 Accepting new patients

Locations

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

368 Broadway
Ste 303
Kingston, NY 12401
Phone (845) 338-7140

Interoperability endpoints

  • Direct secure messaging: mtack@direct.health-quest.org
  • Direct secure messaging: mtack@mahv.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1376582015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACK",
        "first_name": "MARC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "191978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.