Tara Barrack, PA-C
NPI 1104266865ActiveIndividual· Physician Assistant, Surgical· Maple Grove, MN
Physician Assistant, Surgical (PA-C) with Park Nicollet Clinic and 1 other group, practicing in Maple Grove, Minnesota. 224 Medicare patients in 2024, $54,066 paid; all of their 193 Part D prescriptions were generic. Lists Park Nicollet Methodist Hospital as a hospital affiliation.
Overview
| NPI | 1104266865 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jun 26, 2013 |
| Last updated in NPPES | Apr 14, 2020 |
| Certified by provider | Apr 14, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | — | — |
| Physician Assistant | 363A00000X | 11382 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 224 |
|---|---|
| Services billed | 6,043 across 19 procedure codes |
| Paid by Medicare | $54,066 |
Part D prescriptions in 2024
| Prescriptions (claims) | 193 · 217 30-day fills |
|---|---|
| Patients | 104 |
| Total drug cost | $1,420 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Physician Assistant |
| Telehealth | Offers telehealth |
Medical groups
- Park Nicollet ClinicSt Louis Park, MN · 1,787 clinicians
- Tria Orthopaedic Center LLCWoodbury, MN · 515 clinicians
Hospital affiliation
- Park Nicollet Methodist HospitalSaint Louis Park, MN
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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