Individual provider Active NPI

Michael James Tucker Jr, DO

  • Orthopaedic Surgery Physician
  • Joplin, MO
National Provider Identifier
1073703187
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2025004183 Issued in MO
Practice address
3105 McClelland Blvd
Joplin, MO 64804-1640
Phone
(417) 347-5400
Fax
(417) 347-5709
NPI assigned
Jul 26, 2007
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101017371 MI
Orthopaedic Surgery Physician 207X00000X 2025004183 MO Primary

Addresses

Primary practice location

3105 McClelland Blvd
Joplin, MO 64804-1640

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-5400

Other practice location 1

900 Cooper Ave
Suite 3100
Saginaw, MI 48602-5182
Phone (989) 583-7450

Other identifiers 1

IdentifierTypeStateIssuer
1073703187MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131015000870 MI Practitioner - Orthopedic Surgery 1557519246 Reassigns benefits to 2 organizations
I20250616003440 MO Practitioner - Orthopedic Surgery 1557519246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of New England, College of Osteo Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

3105 McClelland Blvd
Joplin, MO 64804-1640
Phone (417) 347-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101017371MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Apr 1, 2020 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Covenant Medical Center, Inc Orthopaedic Surgery CurrentSince Aug 1, 2013 Accepting new patients
Freeman-Oak Hill Health System Orthopaedic Surgery CurrentSince Apr 2, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Orthopaedic Surgery CurrentSince Apr 1, 2020 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2900 Hannah Blvd
Ste B102
East Lansing, MI 48823
Phone (517) 364-8050

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

900 Cooper Ave
Ste 3100
Saginaw, MI 48602
Phone (989) 583-5626

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1073703187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-5400",
            "fax_number": "417-347-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 MCCLELLAND BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041640",
            "telephone_number": "417-347-5400",
            "fax_number": "417-347-5709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Cooper Ave",
            "address_2": "Suite 3100",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025182",
            "country_code": "US",
            "telephone_number": "989-583-7450",
            "fax_number": "989-583-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER JR",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101017371",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2025004183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073703187",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.