Evan G Tacey

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

20 N 2ND St Ste 103
Niles, MI 49120-2259

Phone

(269) 262-1815

NPI assigned

May 24, 2022

Sex

Male

Sole proprietor

Yes

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 MI

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

Family Practice

Education

Michigan State University College of Human Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

Medicare enrollment (NPD)

Enrolled

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.

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490
  Medicare reassignment Care Compare group NPD
• Mymichigan Medical Center Midland

  • Anesthesiology Physician
  • Midland, MI
  • NPI 1649010455
  NPD

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

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1700524253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N 2ND ST STE 103",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202259",
            "telephone_number": "269-262-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N 2ND ST STE 103",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202259",
            "telephone_number": "269-262-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACEY",
        "first_name": "EVAN",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James E Strycker, MD
• Kristine Stubelt, LLP
• Imani Sullivan
• Summerville 2, LLC
• Patrice L Summerville
• Tracy J Tacket, DO
• Ellen Tambunan, M.D.
• Stephen Williams Tankersley, DDS
• Rebecca Tirrell Taulbee, ARNP
• Robert John Taylor Jr., ATC,CSCS,NASM-PES

• Social Worker in Niles, MI
• Providers in Niles, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.