Cody Daniel Tucholke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1415 Lilac Dr N Ste 190
Minneapolis, MN 55422-4544

Phone

(763) 267-8701

NPI assigned

Feb 22, 2022

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accurate Home Care Home health agency, Otsego, MN, CCN 248129
• Lifespark Home Health Home health agency, Saint Louis Park, MN, CCN 248118

Merit-based Incentive Payment System (MIPS)

Final score

86.11 of 100Reported as group

Quality

70.97

Improvement activities

40

Cost

73.58

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Twin Cities Physicians Professional Corporation

  • Multi-Specialty Clinic/Center
  • Golden Valley, MN
  • NPI 1992176499
  Medicare reassignment Care Compare group

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

• Accurate Home Care, LLC

  • Home Health Agency
  • Otsego, MN
  • NPI 1689723207
  Care Compare affiliation
• Lifespark Home Health LLC

  • Home Health Agency
  • St Louis Park, MN
  • NPI 1407223282
  Care Compare affiliation

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407502024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 YORKSHIRE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162404",
            "telephone_number": "612-269-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCHOLKE",
        "first_name": "CODY",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2023-03-07",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "14001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tubman
• David E Tubman, M.D.
• Kathryn Marie Tubman, MS, CCC-SLP
• Cecilia L Tubolino, NNP
• Smyrna Tuburan, MD
• Mary Margaret Tuchscherer, D.C., PH.D.
• Christopher Garrison Tucker, MD
• Cole Thomas Tucker
• Jacqueline Tucker, MD
• Lanning Tucker, ATC, LAT, ATR

• Physician Assistant in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.