MR. CODY DANIEL TUCHOLKE PA-C
NPI 1407502024
Physician Assistant in Minneapolis, MN

Q: What is Cody Tucholke's NPI number?

The NPI number for Cody Tucholke is 1407502024. It was assigned to this individual provider in the NPPES registry on February 22, 2022.

Q: What is Cody Tucholke's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Cody Tucholke was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since February 22, 2022PECOS EnrolledAccepts Medicare Assignment

86.04/100

CMS Quality Rating

1415 LILAC DR N STE 190, MINNEAPOLIS, MN 55422(763) 267-8701 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Apr 21, 2022, Feb 22, 2022 (3 updates tracked since 2022).

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About Mr. Cody Daniel Tucholke Pa-c NPPES

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

MR. CODY DANIEL TUCHOLKE PA-C (NPI 1407502024) is an individual physician assistant in Minneapolis, Minnesota and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1407502024

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. CODY DANIEL TUCHOLKECredential: PA-C

Location Address1415 LILAC DR N STE 190Minneapolis, MN 55422-4544

Mailing Address1856 Yorkshire AveSaint Paul, MN 55116-2404 · (612) 269-6187

Phone(763) 267-8701

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 22, 2022

Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration

NPPES CertifiedApril 21, 2022

✔ NPI 1407502024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

1415 LILAC DR N STE 190, Minneapolis, MN 55422

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Other Identifiers 1

Other14001MN · Pa License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Cody Daniel Tucholke Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496140949

PECOS Enrollment IDI20220318001284

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

236 services40 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

180 services36 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

28 services28 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

25 services16 patients

Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month 99491

Chronic care management services involve a healthcare professional personally providing care for patients with two or more chronic conditions. This service, offered monthly, focuses on the first 30 minutes of care, helping manage and coordinate the patient's health needs.

13 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240053

Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.04/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

83.97

Improvement Activities

Cost

49.53

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.

DR. CLEMENCIA RASQUINHA M.D

Family Medicine (Geriatric Medicine)