Clint M Tucker, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

46666 Issued in KY

Practice address

310 E Broadway
Suite 200
Louisville, KY 40202-1745

Phone

(502) 585-5249

Fax

(502) 585-5251

NPI assigned

Apr 14, 2010

Last updated

Aug 17, 2015By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, IN2 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

Specialty

Dermatology

Education

University of Louisville School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr William M Parsley MD PSCGroup PAC ID 1951378850, 6 clinicians

Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctucker@vitalskinderm.emadirect.md

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.

• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • New Albany, IN
  • NPI 1477297083

  KY

  Medicare reassignment Care Compare group NPD
• Dr William M Parsley MD PSC

  • Dermatology Physician
  • Louisville, KY
  • NPI 1235245754
  Medicare reassignment Care Compare group
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316

  Dermatology

  Medicare reassignment NPD
• Have a Heart Foundation Inc

  • Cardiovascular Disease Physician
  • Louisville, KY
  • NPI 1881182657
  NPD
• University of Louisville Physicians, Inc.

  dba ULP Radiological Associates

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• University of Louisville Physicians, Inc.

  dba ULP Oncology

  • Hematology & Oncology Physician
  • Louisville, KY
  • NPI 1831464940
  NPD
• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • Mattoon, IL
  • NPI 1063030252
  NPD

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1629394713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249",
            "fax_number": "502-585-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249",
            "fax_number": "502-585-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CLINT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "46666",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "164546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000867381",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1728238",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misha Nicole Tsozik, L.M.T., N.C.T.M
• Thomas M Tu, M.D.
• Jasmine Ashley Tuazon, MD, PHD
• Alison Ann Tucker, M.D.
• Amber M Tucker, LMT
• Craig L Tucker, M.D.
• Danielle Elizabeth Tucker, ADULT PEER SUPPORT
• Dara Tucker, NP
• Heather Marie Tucker, ARNP
• Jill Ann Tucker, LPCC

• Dermatology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.