Individual provider Active NPI

David A Tuinstra, PA

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1699726356
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
658 Issued in WI
Practice address
1218 W Kilbourn Ave
Suite 301
Milwaukee, WI 53233-5323
Phone
(414) 765-0010
Fax
(414) 276-1758
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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 658 WI Primary

Addresses

Primary practice location

1218 W Kilbourn Ave
Suite 301
Milwaukee, WI 53233-5323

Mailing address

1218 W Kilbourn Ave Ste 301
Milwaukee, WI 53233-1325
Phone (414) 765-0010

Other practice location 1

975 Port Washington Rd
Suite 110
Grafton, WI 53024-9201
Phone (262) 387-8300

Other identifiers 2

IdentifierTypeStateIssuer
029906261BOtherHUMANA
42933100MedicaidWI

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
I20040803001566 WI Practitioner - Physician Assistant 2668443664 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658WIMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1699726356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE STE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331325",
            "telephone_number": "414-765-0010",
            "fax_number": "414-276-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE",
            "address_2": "SUITE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532335323",
            "telephone_number": "414-765-0010",
            "fax_number": "414-276-1758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Port Washington Rd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "WI",
            "postal_code": "530249201",
            "country_code": "US",
            "telephone_number": "262-387-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUINSTRA",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "029906261B",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42933100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.