DR. DOUGLAS GREGORY TACKET D.O.
NPI 1790764868
Family Medicine in Saint Joseph, MI

Q: What is Douglas Tacket's NPI number?

The NPI number for Douglas Tacket is 1790764868. It was assigned to this individual provider in the NPPES registry on January 17, 2006.

Q: What is Douglas Tacket's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Douglas Tacket was last updated on February 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since January 17, 2006PECOS EnrolledAccepts Medicare Assignment

4077 S CLEVELAND AVE, SAINT JOSEPH, MI 49085(269) 429-2992 Get Directions Write a Review

NPPES record last updated: February 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2021, Jul 1, 2021 (2 updates tracked since 2021).

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About Dr. Douglas Gregory Tacket D.o. NPPES

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

DR. DOUGLAS GREGORY TACKET D.O. (NPI 1790764868) is an individual family medicine provider in Saint Joseph, Michigan, licensed in Michigan (5101012140) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Lakeland Hospital, St Joseph, and maintains a secondary practice location in Middlebury.

NPPES Registry Identity

NPI1790764868

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DOUGLAS GREGORY TACKETCredential: D.O.

Location Address4077 S CLEVELAND AVESaint Joseph, MI 49085-9513

Mailing Address4077 S Cleveland AveSaint Joseph, MI 49085-9513

Phone(269) 429-2992

Sole ProprietorNo

Medical School CMSOtherGraduated 1990

Enumeration DateJanuary 17, 2006

Last NPPES UpdateFebruary 22, 20242 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2024

✔ NPI 1790764868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in MI · 5101012140✔ Licensed in IN · 02001246A

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4077 S CLEVELAND AVE, Saint Joseph, MI 49085

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Secondary Practice Location 1

Location 1206 W Warren StMiddlebury, IN 46540-9410 · Phone (574) 825-2146 · Fax (574) 524-7435

Other Identifiers 5

Medicaid114560327MI

Other0851101104Bcbs

Other236040362IN · Medicare Ptan

Medicaid300049695IN

Other236040362Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Dr. Douglas Gregory Tacket D.o. 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 ID1658279625

PECOS Enrollment IDI20040105000462

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 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

213 services154 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

100 services80 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.

99 services99 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

24 services24 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

22 services22 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.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Lakeland Hospital, St Joseph

Acute Care Hospitals · St Joseph, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230021

Location1234 Napier AvenueSt Joseph, MI 49085 · Berrien County

Emergency services Birthing friendly

Corewell Health Watervliet Hospital

Acute Care Hospitals · Watervliet, MI

OwnershipVoluntary non-profit - Private

CMS Certification Number230078

Location400 Medical Park DrWatervliet, MI 49098 · Berrien County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49085 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers25 claims59 services$5.70 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

3 suppliers29 claims29 services$92.87 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers17 claims17 services$32.45 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 7

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

MS. HILARY CHRISTINE SLEMP N.P.

Nurse Practitioner (Family)