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

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 Name	Tyler Clack
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	1105 6th St, Traverse City, Michigan
Accepts Medicare Assignments	Medicare 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.

Identifier	Type	State	Issuer
1891407136	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse 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 Name	Munson Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821398322 PECOS PAC ID: 8820277015 Enrollment ID: O20110120000061

Entity Name	Munson Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710735287 PECOS PAC ID: 3072426287 Enrollment ID: O20250131002194

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 Address	Practice 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
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
Stephanie Mae Swanson, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4100 Park Forest Dr Ste 210, Traverse City, MI 49684 Phone: 231-935-5770

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