KEVIN L TACK M.D.
NPI 1871599605
Internal Medicine - Gastroenterology in Manhasset, NY

Q: What is Kevin Tack's NPI number?

The NPI number for Kevin Tack is 1871599605. It was assigned to this individual provider in the NPPES registry on June 27, 2005.

Q: What is Kevin Tack's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Tack was last updated on December 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 June 27, 2005PECOS EnrolledAccepts Medicare Assignment

1615 NORTHERN BLVD, MANHASSET, NY 11030(516) 627-3717(516) 869-8625 Get Directions Write a Review

NPPES record last updated: December 4, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kevin L Tack M.d. NPPES

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

KEVIN L TACK M.D. (NPI 1871599605) is an individual gastroenterology provider in Manhasset, New York, licensed in New York (180244) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with North Shore University Hospital, and is a graduate of State University Of New York At Buffalo School Of Medicine (1988).

NPPES Registry Identity

NPI1871599605

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameKEVIN L TACKCredential: M.D.

Location Address1615 NORTHERN BLVDManhasset, NY 11030-3033

Mailing Address1615 Northern BlvdManhasset, NY 11030-3033 · (516) 627-3717 · Fax (516) 869-8625

Phone(516) 627-3717

Fax(516) 869-8625

Sole ProprietorNo

Medical School CMSState University Of New York At Buffalo School Of MedicineGraduated 1988

Enumeration DateJune 27, 2005

Last NPPES UpdateDecember 4, 2009

✔ NPI 1871599605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NY · 180244

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1615 NORTHERN BLVD, Manhasset, NY 11030

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Other Identifiers 2

Medicare UPINF51762NY

Medicare PIN47H441NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin L Tack M.d. 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 ID547217465

PECOS Enrollment IDI20050404000337

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 Reassignments

Medicare enrollment records show Kevin Tack reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mount Sinai School Of Medicine

Same address

Internal Medicine

1615 NORTHERN BLVD
Manhasset, NY 11030

Reassigned Medicare billing, New York enrollment
99 clinicians in this Medicare group

NPI 1144659749 (516) 627-3717

North Shore Medical Group Of The Mount Sinai School Of Medicine

13 mi

Internal Medicine

2020 WANTAGH AVE
Wantagh, NY 11793

Reassigned Medicare billing, New York enrollment
572 clinicians in this Medicare group

NPI 1992417323 (516) 961-4545

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

Areas of Expertise CMS Part B claims 8

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 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.

339 services308 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

182 services182 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

138 services138 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

110 services110 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

87 services86 patients

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.

52 services51 patients

Hospital Affiliations CMS Care Compare 3

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

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330106

Location300 Community DriveManhasset, NY 11030 · Nassau County

Emergency services Birthing friendly

St Francis Hospital - The Heart Center

Acute Care Hospitals · Roslyn, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number330182

Location100 Port Washington BoulevardRoslyn, NY 11576 · Nassau County

Emergency services

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330214

Location550 First AvenueNew York, NY 10016 · New York County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11030 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

$154.28 typical visit price

range $67.40 – $203.53

Typical copayment $38.57 (range $16.85 – $50.88)

Most-billed visit code 99204

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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 20

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

MOUNT SINAI SCHOOL OF MEDICINE

Internal Medicine

1615 NORTHERN BLVD
MANHASSET, NY 11030

Nassau County (516) 627-3717

KATHERINE FRANGOS AUDIOLOGY, P.C.

Clinic/Center (Hearing and Speech)

1615 NORTHERN BLVD, SUITE 201
MANHASSET, NY 11030

Nassau County (516) 365-7952

MANHASSET EYE PHYSICIANS, P.C.

Specialist

1615 NORTHERN BLVD, SUITE 202
MANHASSET, NY 11030

Nassau County (516) 627-0146

MR. KIHO LEE L.AC

Acupuncturist

1615 NORTHERN BLVD, SUITE 202
MANHASSET, NY 11030

Nassau County (917) 945-8780

DR. RICHARD J TRONGONE M.D.

Obstetrics & Gynecology

1615 NORTHERN BLVD, SUITE 106
MANHASSET, NY 11030

Nassau County (516) 365-2500

KATHERINE ANASTASIA FRANGOS

Audiologist

1615 NORTHERN BLVD, SUITE 201
MANHASSET, NY 11030

Nassau County (516) 365-7952

SHERRY REILL ANP-C

Nurse Practitioner (Adult Health)

1615 NORTHERN BLVD, SUITE 301
MANHASSET, NY 11030

Nassau County (516) 732-1422

MARIA BROUNTZAS M.D.

Internal Medicine

1615 NORTHERN BLVD
MANHASSET, NY 11030

Nassau County (516) 627-3717

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 Kevin Tack's NPI number?

The NPI number for Kevin Tack is 1871599605. It was assigned to this individual provider in the NPPES registry on June 27, 2005.

Where is Kevin Tack located?

Kevin Tack practices at 1615 Northern Blvd, Manhasset, NY 11030. The listed phone number is (516) 627-3717.

What is Kevin Tack's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Kevin Tack enrolled in Medicare?

Yes. Kevin Tack 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.

Which organizations bill Medicare for Kevin Tack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Tack reassigns Medicare benefits to 2 organizations: Mount Sinai School Of Medicine (Manhasset, NY) and North Shore Medical Group Of The Mount Sinai School Of Medicine (Wantagh, NY). Each 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 Kevin Tack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kevin Tack affiliated with any hospitals?

According to CMS data, Kevin Tack is affiliated with North Shore University Hospital, St Francis Hospital - The Heart Center and Nyu Langone Hospitals.

When was this NPI record last updated?

The NPPES record for Kevin Tack was last updated on December 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.