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NANAKI TISACK
NPI 1124636378
Internal Medicine - Pulmonary Disease in Royal Oak, MI

Active since July 14, 2020PECOS Enrolled
3535 W 13 MILE RD STE 344, ROYAL OAK, MI 48073(248) 551-0497 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2025, Feb 4, 2025, Jul 14, 2020 (3 updates tracked since 2020).

About Nanaki Tisack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NANAKI TISACK (NPI 1124636378) is an individual pulmonary disease provider in Royal Oak, Michigan, licensed in Michigan (4351049150) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124636378
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameNANAKI TISACK
Location Address3535 W 13 MILE RD STE 344Royal Oak, MI 48073-6770
Mailing Address3601 W 13 Mile RdRoyal Oak, MI 48073-6712
Phone(248) 551-0497
Sole ProprietorNo
Enumeration DateJuly 14, 2020
Last NPPES UpdateMay 21, 20253 updates tracked since enumeration
NPPES CertifiedMay 10, 2025
✔ NPI 1124636378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in MI · 4351049150
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 4351049150 (MI)
3535 W 13 MILE RD STE 344, Royal Oak, MI 48073
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nanaki Tisack is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VISHAL K PATEL MD
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
WAHEEDA NAZNEEN M.D.,
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
STANLEY SHERMAN MD
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
DR. CHRISTOPHER DEEB DADO M.D.
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
KELLY P. SMITH NP
Nurse Practitioner
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
VASHISTHA MAHESHBHAI PATEL MD
Internal Medicine
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
DR. PAUL DOUGLAS BOZYK M.D.
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497
BHAVINKUMAR DALAL MD
Internal Medicine (Pulmonary Disease)
3535 W 13 MILE RD STE 344
ROYAL OAK, MI 48073
Oakland County (248) 551-0497

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nanaki Tisack's NPI number?

The NPI number for Nanaki Tisack is 1124636378. It was assigned to this individual provider in the NPPES registry on July 14, 2020.

Where is Nanaki Tisack located?

Nanaki Tisack practices at 3535 W 13 Mile Rd Ste 344, Royal Oak, MI 48073. The listed phone number is (248) 551-0497.

What is Nanaki Tisack's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Nanaki Tisack enrolled in Medicare?

Yes. Nanaki Tisack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nanaki Tisack was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.