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

Michael Tucker, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1417332321

Michael Tucker, PHYSICIANASSISTANT is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2015, 11 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
11
Licensed in
WI
In the registry since
2015
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Practice location Address checks out

5171 N Santa Monica Blvd Apt 4
Milwaukee, WI 53217-5538
Phone: (414) 828-7761
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3630-23 (WI)

Record details

NPI number1417332321
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedJuly 22, 2015
Last updated in NPPESDecember 2, 2021
Certification dateDecember 2, 2021
Mailing address5171 N Santa Monica Blvd, Apt 4, Milwaukee, WI 53217-5538

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Milwaukee