DR. NANA YAA TACKIE (MD) – Emergency Medicine Physician, NPI 1407114291
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,171 EMERGENCY MEDICINE in MN
Provider Addresses for DR. NANA YAA TACKIE (MD)
1027 WASHINGTON AVE
DETROIT LAKES, MN 565013409
Phone: (218) 847-5611
Fax: (218) 847-0881
Type: Location
5825 BUFORD HWY STE 300
NORCROSS, GA 300712504
Phone: (770) 209-2787
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-09-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130904000429 | I | Emergency Medicine | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 97 | 96 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 58 | 57 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 12 | 12 | $0 |
Insurance plans in this area (ZIP 56501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Family Practice | GA | |
| Family Practice | GA | |
| Internal Medicine | GA | |
| Emergency Medicine, Family Practice | GA | |
| Family Practice, Emergency Medicine | GA | |
| Emergency Medicine, Family Practice | GA |
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