Individual provider Active NPI

Therese Anne Chan Tack, D.O

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1750569950
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10551 Issued in CA
Practice address
3937 25TH St
San Francisco, CA 94114-3812
Phone
(415) 294-1462
NPI assigned
Feb 11, 2008
Last updated
Feb 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A10551 CA Primary

Addresses

Primary practice location

3937 25TH St
San Francisco, CA 94114-3812

Mailing address

3937 25TH St
San Francisco, CA 94114-3812
Phone (415) 294-1462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130824000085 CA Practitioner - Internal Medicine 3870736762 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

400 Parnassus Ave
San Francisco, CA 94143-2202
Phone (415) 476-1000

400 Parnassus Ave
McB300
San Francisco, CA 94143-0810
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10551CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Internal Medicine CurrentSince Mar 14, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 14, 2016 Accepting new patients
County of Santa Clara CurrentSince Jan 1, 2015 Accepting new patients
UCSF Medical Group Business Services Internal Medicine CurrentSince Mar 14, 2016 Accepting new patients
University of California San Francisco CurrentSince Mar 14, 2016 Accepting new patients
County of Santa Clara Current Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Mar 14, 2016 Accepting new patients
University of California San Francisco Current Accepting new patients
County of Santa Clara CurrentSince Jan 1, 2015 Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1545 Divisadero St
Fl 1
San Francisco, CA 94143
Phone (415) 353-7900

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-3131

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Interoperability endpoints

  • Direct secure messaging: tchantack78110@direct-ucsfmedicalcenter.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1750569950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3937 25TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143812",
            "telephone_number": "415-294-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 25TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143812",
            "telephone_number": "415-294-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN TACK",
        "first_name": "THERESE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.