HEATHER TACK NP NPI 1023301595

Nurse Practitioner in Northville, MI

NPI 1023301595 Individual Female Nurse Practitioner PECOS Enrolled

About HEATHER TACK

Heather Tack is a provider established in Northville, Michigan and her medical specialization is nurse practitioner. The NPI number of Heather Tack is 1023301595 and was assigned on May 2011. The practitioner's primary taxonomy code is 363L00000X with license number 4704222690 (MI). The provider is registered as an individual and her NPI record was last updated 8 years ago.

A nurse practitioner (NP) like Heather Tack Np is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Heather Tack is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Heather Tack is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1023301595

Provider Name HEATHER TACK NP
Provider Location Address15474 HAGGERTY RD NORTHVILLE, MI 48170
Provider Mailing Address901 MCCLINTOCK DR SUITE 202 BURR RIDGE, IL 60527
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date05-17-2011
Last Update Date04-19-2013


Primary Taxonomy

Taxonomy Code363L00000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.4704222690
License StateMI
Taxonomy Description(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Business Address

HEATHER TACK NP
15474 HAGGERTY RD
NORTHVILLE, MI
ZIP 48170
Phone: (248) 615-0889
Fax: (734) 404-5317

Get Directions


Mailing Address

HEATHER TACK NP
901 MCCLINTOCK DR
SUITE 202
BURR RIDGE, IL
ZIP 60527
Phone: (888) 220-6432
Fax: (630) 734-4715



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
MI5695012MEDICARE PIN (08)MI

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1760402796DR. COLLEEN S WESTON D.O.
Individual
Internal Medicine (Infectious Disease)15474 HAGGERTY RD
NORTHVILLE, MI 48170
(248) 615-0889
1518035062DR. KALYANI T. MOVVA M.D.
Individual
Specialist15474 HAGGERTY RD
NORTHVILLE, MI 48170
(248) 615-0889
1144513409 LIBBY YU NP
Individual
Nurse Practitioner15474 HAGGERTY RD
NORTHVILLE, MI 48170
(248) 615-0889
1609169184 GRETCHEN MARIE JAKUBIAK NP
Individual
Nurse Practitioner15474 HAGGERTY RD
NORTHVILLE, MI 48170
(734) 335-6103
1275072522 KATHLEEN JAHODA PA-C
Individual
Physician Assistant (Medical)15474 HAGGERTY RD
NORTHVILLE, MI 48170
(734) 355-6103

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.