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

Olivia Grayce Tack, MD

Individual provider Pediatrics Physician · NPI 1255371514

Olivia Grayce Tack, MD is a Pediatric Medicine in Granger, Indiana. Graduated from Michigan State University College of Human Medicine in 2003, 23 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
23
Trained at
Michigan State University College of Human Medicine
Licensed in
IN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

6913 N Main St Ste 200
Granger, IN 46530-8039
Phone: (574) 647-4540
Fax: (574) 647-2567
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 01062281A (IN)

Record details

NPI number1255371514
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 7, 2006
Last updated in NPPESNovember 24, 2025
Certification dateNovember 24, 2025
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated 2003 (23 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Granger