Individual provider Active NPI

Michael Anthony Tiska, P.A-C

  • Physician Assistant
  • Marysville, CA
National Provider Identifier
1952340705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16554 Issued in CA
Practice address
726 4TH Street
Marysville, CA 94901
Phone
(530) 749-4300
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA16554 CA Primary

Addresses

Primary practice location

726 4TH Street
Marysville, CA 94901

Mailing address

2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040430000485 CA Practitioner - Physician Assistant 8426045352 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

1800 N California St
Stockton, CA 95204-6019
Phone (209) 467-6400

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Methodist Hospital of Sacramento Hospital, Sacramento, CA, CCN 050590

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16554CAMDCounselor
PA16554CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jan 26, 2026 Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952340705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 4TH STREET",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "530-749-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISKA",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

Verify at the official NPI Registry.