Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin L Tack, MD

Individual provider Gastroenterology Physician · NPI 1871599605

Kevin L Tack, MD is a Gastroenterology in Manhasset, New York. Graduated from State University of New York at Buffalo School of Medicine in 1988, 38 years ago. Practices with North Shore Medical Group of the Mount Sinai School of Medicine, a 323-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
38
Trained at
State University of New York at Buffalo School of Medicine
Licensed in
NY
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1615 Northern Blvd
Manhasset, NY 11030-3033
Phone: (516) 627-3717
Fax: (516) 869-8625
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 180244 (NY)

Record details

NPI number1871599605
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 27, 2005
Last updated in NPPESDecember 4, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Group practice North Shore Medical Group Of The Mount Sinai School Of Medicine — 323 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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