Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMANTHA TULLY PA-C
NPI 1265399406
Physician Assistant in Milwaukee, WI

Active since January 08, 2026
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 805-6400(414) 955-0213 Get Directions Write a Review

NPPES record last updated: September 9, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 9, 2026, Jul 31, 2026, Jan 8, 2026 (3 updates tracked since 2026).

About Samantha Tully Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA TULLY PA-C (NPI 1265399406) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Wisconsin (8938-023) and active in the NPI registry since January 2026. She maintains a secondary practice location in Waukesha.

NPPES Registry Identity

NPI1265399406
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSAMANTHA TULLYCredential: PA-C
Location Address9200 W WISCONSIN AVEMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin AveMilwaukee, WI 53226-3522 · (414) 805-6400 · Fax (414) 955-0213
Fax(414) 955-0213
Sole ProprietorNo
Enumeration DateJanuary 8, 2026
Last NPPES UpdateSeptember 9, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2026
✔ NPI 1265399406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 8938-023
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
9200 W WISCONSIN AVE, Milwaukee, WI 53226

Secondary Practice Location 1

Location 12140 Davidson RdWaukesha, WI 53186-4008 · Phone (262) 951-3253

Other Identifiers 1

Medicaid1265399406WI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Tully's NPI number?

The NPI number for Samantha Tully is 1265399406. It was assigned to this individual provider in the NPPES registry on January 8, 2026.

Where is Samantha Tully located?

Samantha Tully practices at 9200 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 805-6400.

What is Samantha Tully's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Samantha Tully was last updated on September 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.