Tyler Clack, CRNA
NPI 1891407136ActiveIndividual· Nurse Anesthetist, Certified Registered· Traverse City, MI
Nurse Anesthetist, Certified Registered (CRNA) with Munson Medical Center and 1 other group, practicing in Traverse City, Michigan. Medicare paid $16,021 for services to 165 patients in 2024. Lemaitre Vascular, Inc. reported $25.72 in payments in 2025, mostly food and beverage. Lists Kalkaska Memorial Health Center and 1 other hospital as hospital affiliations.
Overview
| NPI | 1891407136 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CRNA |
| Sole proprietor | Yes |
| NPI issued | Dec 19, 2022 |
| Last updated in NPPES | Dec 19, 2022 |
| Certified by provider | Dec 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 4704339380 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 165 |
|---|---|
| Services billed | 168 across 58 procedure codes |
| Paid by Medicare | $16,021 |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical groups
- Munson Medical CenterTraverse City, MI · 384 clinicians
- Munson Medical GroupTraverse City, MI · 194 clinicians
Hospital affiliations
- Kalkaska Memorial Health CenterKalkaska, MI
- Munson Medical CenterTraverse City, MI
Industry payments (Open Payments)
- 2025$25.72 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Lemaitre Vascular, Inc. | $25.72 | 1 |
What the 2025 payments were for
- Food and Beverage$25.72 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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