Tyler Clack, CRNA - Medicare Nurse Anesthetist, Certified Registered in Traverse City, MI

Tyler Clack, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Traverse City, Michigan. His current practice location is 1105 6th St, Traverse City, Michigan. You can reach out to his office (for appointments etc.) via phone at (231) 935-5000.

Tyler Clack is licensed to practice in Michigan (license number 4704339380) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1891407136.

Contact Information

Tyler Clack, CRNA
1105 6th St,
Traverse City, MI 49684-2345
(231) 935-5000
Not Available

Map and Direction




Provider's Profile

Full NameTyler Clack
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location1105 6th St, Traverse City, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1891407136
  • Provider Enumeration Date: 12/19/2022
  • Last Update Date: 12/19/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8022474899
  • Enrollment ID: I20230520000169

Medical Identifiers

Medical identifiers for Tyler Clack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891407136NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 4704339380 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tyler Clack allows following entities to bill medicare on his behalf.
Entity NameMunson Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821398322
PECOS PAC ID: 8820277015
Enrollment ID: O20110120000061

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler Clack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tyler Clack, CRNA
1105 6th St,
Traverse City, MI 49684-2345

Ph: (231) 935-7690
Tyler Clack, CRNA
1105 6th St,
Traverse City, MI 49684-2345

Ph: (231) 935-5000

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Traverse City, MI

Scott Stone, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747
Christina Dalton Pryde, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747
Mitchell Reynolds, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747
Jonathan P Gunsberg, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747
Reid Compagner,
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: Munson Medical Center, 1105 Sixth Street, Traverse City, MI 49684
Phone: 231-935-7690    
Michelle Hodges, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747
Mona L Mackey, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4100 Park Forest Dr, Suite 210, Traverse City, MI 49684
Phone: 231-935-5770    Fax: 231-935-0747

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.