1. Home
  2. Directory
  3. Maine
  4. Portland
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

STUART TACKETT
NPI 1679411490
Student in an Organized Health Care Education/Training Program in Portland, ME

Active since March 23, 2026PECOS Enrolled
22 BRAMHALL ST, PORTLAND, ME 04102(207) 662-0111 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stuart Tackett NPPES

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

STUART TACKETT (NPI 1679411490) is an individual student in an organized health care education/training program in Portland, Maine and active in the NPI registry since March 2026. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679411490
Entity TypeIndividual
Primary Taxonomy390200000X
Provider Legal NameSTUART TACKETT
Location Address22 BRAMHALL STPortland, ME 04102-3175
Mailing Address22 Bramhall StPortland, ME 04102-3175 · (207) 662-0111
Phone(207) 662-0111
Sole ProprietorNo
Enumeration DateMarch 23, 2026
NPPES CertifiedMarch 23, 2026
✔ NPI 1679411490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
22 BRAMHALL ST, Portland, ME 04102
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stuart Tackett 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.

Other Providers at the Same Location NPPES 20

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

ABBY LYNN LABRECQUE PA-C
Physician Assistant (Medical)
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-8111
TEGAN SWIFT RD
Dietitian, Registered
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-4238
DEREK POULIN DO
Anesthesiology
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2526
MATTHEW SCOTT AUSTIN CRNA
Nurse Anesthetist, Certified Registered
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2526
MADELINE YOUNGBERG MD
Internal Medicine
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111
ERICA BRASLEY MD
Student in an Organized Health Care Education/Training Program
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111
REBECCA ROSE LIGHTMAN
Internal Medicine
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-7060
DR. LUKE PATRICK KEFFER MD, MBA
Student in an Organized Health Care Education/Training Program
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111

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 Stuart Tackett's NPI number?

The NPI number for Stuart Tackett is 1679411490. It was assigned to this individual provider in the NPPES registry on March 23, 2026.

Where is Stuart Tackett located?

Stuart Tackett practices at 22 Bramhall St, Portland, ME 04102. The listed phone number is (207) 662-0111.

What is Stuart Tackett's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Stuart Tackett enrolled in Medicare?

Yes. Stuart Tackett is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stuart Tackett was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.