Individual provider Active NPI

Tara R. Christensen-Tourtillott, PA-C

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1134106263
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1152-023 Issued in WI
Practice address
1575 N Rivercenter Dr
Suite 160
Milwaukee, WI 53212-3978
Phone
(414) 274-7220
Fax
(414) 274-7227
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1152-023 WI Primary

Addresses

Primary practice location

1575 N Rivercenter Dr
Suite 160
Milwaukee, WI 53212-3978

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
42982700MedicaidWI
P00682030OtherWIRR MEDICARE

Other names 1

  • Ms. Tara R. Christensen Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tchristensentourtillott11849@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000190 WI Practitioner - Physician Assistant 1355405242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

2424 S 90TH St
Suite 306
West Allis, WI 53227-2455
Phone (414) 328-8750

2999 N Mayfair Rd
Suite 100
Wauwatosa, WI 53222-4306
Phone (414) 479-7000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1152-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2009 Accepting new patients

Locations

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1575 N Rivercenter Dr
Ste 160
Milwaukee, WI 53212
Phone (414) 274-7220

950 N 12th St
Milwaukee, WI 53233
Phone (414) 219-6036

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

2999 N Mayfair Rd
Ste 100
Wauwatosa, WI 53222
Phone (414) 479-7000

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1134106263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N RIVERCENTER DR",
            "address_2": "SUITE 160",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123978",
            "telephone_number": "414-274-7220",
            "fax_number": "414-274-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN-TOURTILLOTT",
        "first_name": "TARA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1152-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42982700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00682030",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tchristensentourtillott11849@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1575 N Rivercenter Dr",
            "address_2": "Suite 160",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532123978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1575 N Rivercenter Dr",
            "address_2": "Suite 160",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532123978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "CHRISTENSEN",
            "middle_name": "R.",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.