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DIANE ADAKU TACKIE PA-C
NPI 1871894808
Physician Assistant - Medical in Rockville, MD

Active since November 08, 2010PECOS Enrolled
1395 PICCARD DR STE 200, ROCKVILLE, MD 20850(202) 951-7942(202) 971-1991 Get Directions Write a Review

NPPES record last updated: March 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 19, 2026, Jun 4, 2025, May 9, 2025 and 1 more (4 updates tracked since 2025).

About Diane Adaku Tackie Pa-c NPPES

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

DIANE ADAKU TACKIE PA-C (NPI 1871894808) is an individual medical provider in Rockville, Maryland, licensed in Maryland (C04246) and active in the NPI registry since November 2010. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1871894808
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameDIANE ADAKU TACKIECredential: PA-C
Location Address1395 PICCARD DR STE 200Rockville, MD 20850-4348
Mailing Address1395 Piccard Dr Ste 200Rockville, MD 20850-4348 · (202) 951-7942 · Fax (202) 971-1991
Phone(202) 951-7942
Fax(202) 971-1991
Sole ProprietorNo
Enumeration DateNovember 8, 2010
Last NPPES UpdateMarch 19, 20264 updates tracked since enumeration
NPPES CertifiedMarch 19, 2026
✔ NPI 1871894808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MD · C04246
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA031403 (DC)
1395 PICCARD DR STE 200, Rockville, MD 20850
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Other Names 1

Professional Name (2)Diane Tackie Granillo Pa-c

Secondary Practice Locations 3

Location 11350 Connecticut Ave NW Ste 1250Washington, DC 20036-1728 · Phone (888) 663-6331 · Fax (415) 252-7176
Location 21331 H St NW Ste 200Washington, DC 20005-4706 · Phone (888) 803-3370
Location 340 York Rd Ste 110Towson, MD 21204-5243 · Phone (202) 951-7942 · Fax (202) 971-1991

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diane Adaku Tackie Pa-c 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 2

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

DIANE TACKIE GRANILLO, LLC
Physician Assistant (Medical)
1395 PICCARD DR STE 200
ROCKVILLE, MD 20850
Montgomery County (202) 951-7942
WE CARE HOME HEALTH SERVICES, INC.
In Home Supportive Care
1395 PICCARD DR STE 200
ROCKVILLE, MD 20850
Montgomery County (301) 820-8381

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 Diane Tackie's NPI number?

The NPI number for Diane Tackie is 1871894808. It was assigned to this individual provider in the NPPES registry on November 8, 2010. The provider is also known as Diane Tackie Granillo Pa-C.

Where is Diane Tackie located?

Diane Tackie practices at 1395 Piccard Dr Ste 200, Rockville, MD 20850. The listed phone number is (202) 951-7942.

What is Diane Tackie's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Diane Tackie enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Diane Tackie was last updated on March 19, 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.