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

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