Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Cody Daniel Tucholke, PA-C

Individual provider Physician Assistant · NPI 1407502024

Mr. Cody Daniel Tucholke, PA-C is a Physician Assistant in Minneapolis, Minnesota. Qualified in 2022, 4 years ago. Practices with Twin Cities Physicians Professional Corporation, a 66-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1415 Lilac Dr N Ste 190
Minneapolis, MN 55422-4544
Phone: (763) 267-8701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1407502024
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 22, 2022
Last updated in NPPESMarch 7, 2023
Certification dateApril 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Twin Cities Physicians Professional Corporation — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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