Patty Lynn Tucker, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12688 Issued in CA

Practice address

585 W College Ave
Santa Rosa, CA 95401-5000

Phone

(707) 525-9616

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1821058140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 W COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015000",
            "telephone_number": "707-527-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 W COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015000",
            "telephone_number": "707-525-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PATTY",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcaresrmh@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "585 W College Ave",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954015000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Casey L Tucker, DC
• Danielle Tucker
• Dawnmichelle Tucker, RN
• Laura Tucker
• Matthew Williamson Tucker, CMT
• Ronnie Tucker Jr.
• Sarah Michelle Tucker, LMFT
• Sean Tucker
• Stacy Ann Tucker
• Margaret Jorgensen Turano, IBCLC

• Medical Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.