Active NPI
Sarah Nicole Tackett, MPAS
- Physician Assistant
- Elkhart, IN
National Provider Identifier
1497362636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 111 N Nappanee St
Elkhart, IN 46514-1957 - Phone
- (574) 522-0265
- NPI assigned
- Sep 30, 2020
- Last updated
- Mar 31, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
111 N Nappanee St
Elkhart, IN 46514-1957
Mailing address
111 N Nappanee St
Elkhart, IN 46514-1957
Phone (574) 522-0265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Growth Pkwy
Angola, IN 46703-9313
Phone (260) 665-1670
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- kosinskis@docsdermmi.emadirect.md
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1497362636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N NAPPANEE ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141957",
"telephone_number": "574-522-0265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N NAPPANEE ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141957",
"telephone_number": "574-522-0265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "SARAH",
"middle_name": "NICOLE",
"credential": "MPAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-30",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.