NPIMap

Individual provider Active NPI

Kevin P. Tucker, MD

  • Nephrology Physician
  • Milwaukee, WI
National Provider Identifier
1295809036
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
51647 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy Ste 413
Milwaukee, WI 53215-3660
Phone
(414) 383-7744
Fax
(414) 383-8089
NPI assigned
Nov 20, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 51647 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy Ste 413
Milwaukee, WI 53215-3660

Mailing address

2514 S 102ND St
Suite 120
West Allis, WI 53227-2142
Phone (414) 777-5200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevin.tucker@milwaukeenephrologists.directbygreenway.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
I20110601000846 WI Practitioner - NephrologyPractitioner - Internal Medicine 7214114131 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Medical College of Wisconsin, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Nephrologists SCGroup PAC ID 4385538446, 21 clinicians

Practice addresses (Care Compare)

2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3660
Phone (414) 259-8917

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51647WIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Medical SC CurrentSince Mar 15, 2020 Accepting new patients
Oak Medical SC CurrentSince Mar 15, 2020 Accepting new patients
Milwaukee Nephrologists, S.C. Nephrology CurrentSince Jul 18, 2011 Accepting new patients
Garfield Dialysis Venture LLC Past Accepting new patients

Locations

2901 W Kinnickinnic River Pkwy
Ste 413
Milwaukee, WI 53215
Phone (414) 259-8917

2428 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 875-5070

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

601 N 99th St
Ste 302
Wauwatosa, WI 53226
Phone (414) 431-2186

2514 S 102nd St
Ste 120
West Allis, WI 53227

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71975
  • Direct secure messaging: kevin.tucker@milwaukeenephrologists.directbygreenway.com
  • Direct secure messaging: ktucker43429@direct.davitaphysiciansolutions.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1295809036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST",
            "address_2": "SUITE 120",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-777-5200",
            "fax_number": "414-777-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 413",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-383-7744",
            "fax_number": "414-383-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KEVIN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "51647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.tucker@milwaukeenephrologists.directbygreenway.com",
            "affiliation": "N",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 413",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.