← Back to Provider List

CLEMMENSEN, ADAMS, & TACK PSC SOS Verified

Dermatology ยท CARSON CITY, NV

1100 S CARSON ST, CARSON CITY, NV 89701

NPI Number
1780852368
Street View of 1100 S CARSON ST, CARSON CITY, NV 89701

Practice location · View on Google Maps

SOS Verification: Verified
Entity Name: CLEMMENSEN, ADAMS & TACK DERMATOLOGY ASSOCIATES, LTD.
Entity Number: C6146-1981
Entity Type: Domestic Professional Corporation
Entity Status: Default
Formation Date: 1981-09-10
Status Changed: 2013-11-22
Name Match: 43%
Medicaid Payments After Loss of Active Status

This provider's Nevada Secretary of State registration was default on 2013-11-22, but continued receiving Medicaid payments through 2020-0982 months after losing active status.

Nevada law requires healthcare providers to maintain active business registration. Payments to entities without active registration may warrant investigation by the Nevada Attorney General's office.

SOS Status: Default
Registered Agent
Name: Kuckenmeister, LLC
Type: Commercial Registered Agent
Address: 3860 GS Richards Blvd, Carson City, NV, 89703
Research Report
Operates as: Clemmensen, Adams & Tack Dermatology Associates, Ltd. (Corp ID: 183371)
Now operates as Carson Dermatology (carsondermatology.com). NV largest physician-owned dermatology practice. Founded 1979 by Dr. Charles Clemmensen. Current physicians Dr. David Tack and Dr. Max Gratrix match SOS officers. At Carson-Tahoe Hospital campus, 1505 Medical Pkwy. Active Yelp reviews March 2026. Low confidence (43%) because full entity name is Clemmensen Adams & Tack Dermatology Associates Ltd.
Confirmed DBA
Officers / Principals
TitleNameAddressStatus
SecretaryMAX GRATRIX1505 MEDICAL PKWY, Carson City, NVActive
TreasurerDAVID TACK1505 MEDICAL PKWY, Carson City, NVActive
PresidentDAVID TACK1505 MEDICAL PKWY, Carson City, NVActive
DirectorMAX GRATRIX1505 MEDICAL PKWY, Carson City, NVActive
Campaign Contributions
$500Total Contributed
Officer / Individual Matches
TACK, DAVID ALANPossible Match
Matched via officer: DAVID TACK (Treasurer)
$500 across 1 contribution
Data Notice Campaign contribution matches are based on automated name matching against Nevada Secretary of State campaign finance records. Corporate matches compare registered business names. Officer matches compare individual names and may include false positives due to common names. Contributions are to Nevada state and local candidates only.
Total Medicaid Payments
$2,195
-100% vs specialty average
Patients Seen
40
Total Claims
41
$ Per Patient
$55
Specialty avg: $63
Specialty Rank
#18 of 23
Dermatology providers in Nevada
Peer Average
$636,127
Average total for Dermatology
Claims per Patient
1.0
Average visits / services per person

Payments by Year

How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.

Year Total Paid % of Max
2019$545
2020$1,650

Procedure Code Breakdown

The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.

HCPCS Code Description Claims Paid % of Total Avg per Claim
88305Tissue examination under a microscope (surgical pathology)13$1,138
51.8%
$88
99213Office visit for a simple problem (established patient)28$1,057
48.2%
$38

About This Data

This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.