1. Home
  2. Directory
  3. Texas
  4. Dallas
  5. Nurse Practitioner
  6. NPI Profile

TIFFANY LEAH CLACK MSN-ANP
NPI 1376817221
Nurse Practitioner - Adult Health in Dallas, TX

Active since February 23, 2012PECOS EnrolledAccepts Medicare Assignment
712 N. WASHINGTON AVE, SUITE 415, DALLAS, TX 75246(214) 820-9115(214) 820-9135 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tiffany Leah Clack Msn-anp NPPES

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

TIFFANY LEAH CLACK MSN-ANP (NPI 1376817221) is an individual adult health provider in Dallas, Texas, licensed in Texas (765246) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott And White Medical Center Mckinney, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1376817221
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameTIFFANY LEAH CLACKCredential: MSN-ANP
Location Address712 N. WASHINGTON AVE, SUITE 415Dallas, TX 75246-1800
Mailing Address712 N Washington Ave, Suite 415Dallas, TX 75246-1619 · (214) 820-9115 · Fax (214) 820-9135
Phone(214) 820-9115
Fax(214) 820-9135
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateFebruary 23, 2012
Last NPPES UpdateMarch 30, 2022
NPPES CertifiedMarch 30, 2022
✔ NPI 1376817221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in TX · 765246
712 N. WASHINGTON AVE, Dallas, TX 75246
Open in Google Maps ↗

Other Identifiers 1

Medicaid294800201TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tiffany Leah Clack Msn-anp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527229632
PECOS Enrollment IDI20120417000865
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.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
307 services122 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
113 services71 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
112 services88 patients
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
97 services69 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
92 services50 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
56 services56 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor Scott And White Medical Center Mckinney

Acute Care Hospitals · Mc Kinney, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670082
Location5252 West University DriveMc Kinney, TX 75071 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75246 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, fixed height, with any type side rails, with mattress E0250
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$41.95 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier25 claims25 services$69.05 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

ISA MANAGEMENT SERVICES, LLC
Pharmacy (Community/Retail Pharmacy)
712 N. WASHINGTON AVE, STE 500
DALLAS, TX 75246
Dallas County (469) 466-1243

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 Tiffany Clack's NPI number?

The NPI number for Tiffany Clack is 1376817221. It was assigned to this individual provider in the NPPES registry on February 23, 2012.

Where is Tiffany Clack located?

Tiffany Clack practices at 712 N. Washington Ave Suite 415, Dallas, TX 75246. The listed phone number is (214) 820-9115.

What is Tiffany Clack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Tiffany Clack enrolled in Medicare?

Yes. Tiffany Clack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tiffany Clack accept?

Health plans from Blue Cross and Blue Shield of Texas list Tiffany Clack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tiffany Clack affiliated with any hospitals?

According to CMS data, Tiffany Clack is affiliated with Baylor Scott And White Medical Center Mckinney.

When was this NPI record last updated?

The NPPES record for Tiffany Clack was last updated on March 30, 2022. 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.