NPIMap

Individual provider Active NPI

Tiffany Luckey

  • Physician Assistant
  • Greenwood, WI
National Provider Identifier
1245784453
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3988 Issued in WI
Practice address
102 Cannery St
Marshfield Clinic Greenwood Center
Greenwood, WI 54437-9705
Phone
(715) 267-6600
Fax
(715) 267-6917
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 3988 WI Primary

Addresses

Primary practice location

102 Cannery St
Marshfield Clinic Greenwood Center
Greenwood, WI 54437-9705

Mailing address

102 Cannery St
Marshfield Clinic Greenwood Center
Greenwood, WI 54437-9705
Phone (715) 267-6600

Other practice location 1

1011 E Spruce St
Suite 6, East Town Mall
Abbotsford, WI 54405-9647
Phone (715) 223-3278

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170406000763 WI Practitioner - Physician Assistant 3971889924 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital Inc 41 clinicians

Practice addresses (Care Compare)

N3708 River Ave
Neillsville, WI 54456-7218
Phone (715) 743-3101

Hospital & facility affiliations

  • Compassus Home Health Home health agency, Marshfield, WI, CCN 527189
  • Marshfield Medical Center - Neillsville Hospital, Neillsville, WI, CCN 521323
  • Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3988WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Apr 12, 2021 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Apr 12, 2021 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 12, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 12, 2021 Accepting new patients
Memorial Hospital Inc CurrentSince Apr 12, 2021 Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

102 Cannery St
Greenwood, WI 54437
Phone (715) 267-6600

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

Interoperability endpoints

  • Direct secure messaging: tiffany.luckey@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

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 4

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": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1245784453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CANNERY ST",
            "address_2": "MARSHFIELD CLINIC GREENWOOD CENTER",
            "city": "GREENWOOD",
            "state": "WI",
            "postal_code": "544379705",
            "telephone_number": "715-267-6600",
            "fax_number": "715-267-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CANNERY ST",
            "address_2": "MARSHFIELD CLINIC GREENWOOD CENTER",
            "city": "GREENWOOD",
            "state": "WI",
            "postal_code": "544379705",
            "telephone_number": "715-267-6600",
            "fax_number": "715-267-6917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 E Spruce St",
            "address_2": "Suite 6, East Town Mall",
            "address_purpose": "LOCATION",
            "city": "Abbotsford",
            "state": "WI",
            "postal_code": "544059647",
            "country_code": "US",
            "telephone_number": "715-223-3278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "102 Cannery St",
            "address_2": "Marshfield Clinic Greenwood Center",
            "city": "Greenwood",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544379705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, WI

Sources for this page

Verify at the official NPI Registry.