AMI KATHLEEN TUCKER (NP) – Family Nurse Practitioner, NPI 1093495004

AMI KATHLEEN TUCKER (NP) is a healthcare provider. based in Granite bay, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 95026044 (CA). The NPI Number for AMI KATHLEEN TUCKER (NP) is 1093495004

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
AMI KATHLEEN TUCKER (NP)
NPI
1093495004
Phone
(919) 600-4564
Address
6518 PUEBLO CT
Enumeration Date
24 July 2023
Last Update Date
24 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9164694690
Graduation Year
2023 (3 years ago)
PAC ID
2668835612
Group Practice PAC ID
8426157975
Professional Enrollment ID
I20230824000950
Address ID
CA956102372CI7777XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for AMI KATHLEEN TUCKER (NP)

  • 6518 PUEBLO CT

    GRANITE BAY, CA 957469652

    Phone: (919) 600-4564

    Type: Mailing

  • 5959 GREENBACK LN STE 500

    CITRUS HEIGHTS, CA 956214700

    Phone: (916) 737-5555

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $214.

Total Amount is formed as General ($214) + Research ($0) + Ownership ($0) = $214.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Dexcom, Inc. ($81).

Total Amount

$214

General + Research + Ownership

Payments

9

Total payment records

General Amount

$214

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230824000950INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95746)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426157975View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineCA
P S Y C H I A T R YCA
Family Practice, Emergency MedicineCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Clinical Social WorkerCA
Family PracticeCA
E N D O C R I N O L O G YCA
Internal Medicine, Pediatric MedicineCA
Physician AssistantCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What number should I use to identify AMI KATHLEEN TUCKER (NP) for billing?
Administrative and clinical systems typically use NPI 1093495004 for AMI KATHLEEN TUCKER (NP).
Should I treat AMI KATHLEEN TUCKER (NP) as an active provider?
Patients and plans typically see AMI KATHLEEN TUCKER (NP) as active in the national extract.
What type of care does AMI KATHLEEN TUCKER (NP) provide?
AMI KATHLEEN TUCKER (NP)'s profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to AMI KATHLEEN TUCKER (NP)?
The directory associates AMI KATHLEEN TUCKER (NP) with Granite Bay, California. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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