Samuel Tacke (NPI# 1235236993, PAC ID# 2264530724) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1235236993 |
| PAC ID by PECOS | 2264530724 |
| Professional Enrollment ID | I20081205000601 |
| Full Name | Samuel Tacke |
| Organization Legal Name | MERCED ORTHOPAEDIC MEDICAL GROUP |
| Address |
123 W N Bear Creek Dr Medical Group Inc Merced CA 95348-3420 |
| Phone Number | 2097228161 |
| Gender | M |
| Medical School | UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 6800994369 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050444 | MERCY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 123 W N Bear Creek Dr, Medical Group Inc, Merced, CA 95348-3420 | 2097228161 | MERCED ORTHOPAEDIC MEDICAL GROUP |
| Organization Legal Name | MERCED ORTHOPAEDIC MEDICAL GROUP |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy S Wootten | Physician Assistant | Merced Orthopaedic Medical Group | 123 W N Bear Creek Dr, Medical Group Inc, Merced, CA 95348-3420 |
| Mark W Via | Orthopedic Surgery | Merced Orthopaedic Medical Group | 123 W N Bear Creek Dr, Medical Group Inc, Merced, CA 95348-3420 |
| Street Address |
123 W N BEAR CREEK DR MEDICAL GROUP INC |
| City | MERCED |
| State | CA |
| Zip | 95348-3420 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy S Wootten | Physician Assistant | Merced Orthopaedic Medical Group | 123 W N Bear Creek Dr, Medical Group Inc, Merced, CA 95348-3420 |
| Mark W Via | Orthopedic Surgery | Merced Orthopaedic Medical Group | 123 W N Bear Creek Dr, Medical Group Inc, Merced, CA 95348-3420 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Neil R Nebeker | Optometry | 197 W El Portal Dr A, Merced, CA 95348-0928 | |
| William A Goggin | Clinical Social Worker | 1160 Olivewood Dr, Suite A9, Merced, CA 95348-1210 | |
| Atulkumar T Roy | Nephrology | Central Valley Nephrology Medical Associates Incorporated | 1140 Olivewood Dr, Merced, CA 95348-1210 |
| Pamela Roussos | Family Medicine | 1146 Olivewood Dr, Merced, CA 95348-1210 | |
| Daniel F Ikemiyashiro | Nephrology | Central Valley Nephrology Medical Associates Incorporated | 1140 Olivewood Dr, Merced, CA 95348-1210 |
| Brett K Reed | Chiropractic | 1190 Olivewood Dr, D, Merced, CA 95348-1256 | |
| Bryant Owens | Chiropractic | 1180 W Olive Ave, Suite I, Merced, CA 95348-1900 | |
| Satnam Uppal | Internal Medicine | 1190 W Olive Ave L, Merced, CA 95348-1960 | |
| Nanci Adinolfi | Physician Assistant | Children and Family Medical Care Inc | 1190 W Olive Ave L, Merced, CA 95348-1960 |
| Jean B Luckman | Clinical Social Worker | 1037 W Yosemite Ave, Suite 4, Merced, CA 95348-2162 | |
| Find all physicians in zip 95348 | |||
| City | MERCED |
| Zip Code | 95348 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | MERCED + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Samuel Tacke.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.