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IRMGARD UNA TACKIE MD
NPI 1215168653
Pediatrics in Fontana, CA

Active since August 03, 2009PECOS Enrolled
15290 SUMMIT AVE, SUITE B, FONTANA, CA 92336(909) 225-1900 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Irmgard Una Tackie Md NPPES

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

IRMGARD UNA TACKIE MD (NPI 1215168653) is an individual pediatrics provider in Fontana, California, licensed in California (A118539) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215168653
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameIRMGARD UNA TACKIECredential: MD
Location Address15290 SUMMIT AVE, SUITE BFontana, CA 92336-0240
Mailing Address16096 Pitzer StFontana, CA 92336-4530 · (865) 591-1988
Phone(909) 225-1900
Sole ProprietorNo
Enumeration DateAugust 3, 2009
Last NPPES UpdateDecember 8, 2021
NPPES CertifiedDecember 8, 2021
✔ NPI 1215168653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A118539
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
15290 SUMMIT AVE, Fontana, CA 92336
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Irmgard Una Tackie Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Irmgard Tackie reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

San Marcos Medical Group Inc
0.5 mi
Obstetrics & Gynecology
14980 SUMMIT AVE STE 230
Fontana, CA 92336
  • Reassigned Medicare billing, California enrollment
  • 49 clinicians in this Medicare group
NPI 1447446448 (909) 376-4438

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92336 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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 2

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

GOLDSTAR PEDIATRICS PC
Pediatrics
15290 SUMMIT AVE, SUITE B
FONTANA, CA 92336
San Bernardino County (909) 225-1900
DR. HOAN-VU TRUONG DMD
Dentist (General Practice)
15290 SUMMIT AVE, SUITE D
FONTANA, CA 92336
San Bernardino County (909) 899-8811

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 Irmgard Tackie's NPI number?

The NPI number for Irmgard Tackie is 1215168653. It was assigned to this individual provider in the NPPES registry on August 3, 2009.

Where is Irmgard Tackie located?

Irmgard Tackie practices at 15290 Summit Ave Suite B, Fontana, CA 92336. The listed phone number is (909) 225-1900.

What is Irmgard Tackie's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Irmgard Tackie enrolled in Medicare?

Yes. Irmgard Tackie is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Irmgard Tackie's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Irmgard Tackie reassigns Medicare benefits to San Marcos Medical Group Inc (Fontana, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Irmgard Tackie's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Irmgard Tackie was last updated on December 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.