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

Mrs. Michelle L. Tautkus, PA-C

Individual provider Physician Assistant · NPI 1053319038

Mrs. Michelle L. Tautkus, PA-C is a Physician Assistant in Warwick, Rhode Island. Qualified in 2004, 22 years ago. Practices with Beth Israel Lahey Health Primary Care, Inc, a 353-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts and Rhode Island.

Years since qualifying
22
Licensed in
MA, RI
In the registry since
2005
Specialties on file
3
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

475 Kilvert St Ste 310
Warwick, RI 02886
Phone: (781) 472-8650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 41 Mall Rd, Burlington, MA 01805-0001 — (781) 744-8000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA1856 (MA)
Physician Assistant Taxonomy 363A00000X · Licence 1856 (MA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA00464 (RI)

Record details

NPI number1053319038
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 13, 2005
Last updated in NPPESFebruary 21, 2023
Certification dateFebruary 21, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Beth Israel Lahey Health Primary Care, Inc — 353 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Warwick