TIFFANY LUCKEY – Physician Assistant, NPI 1245784453
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
3,672 PHYSICIAN ASSISTANT in WI
Provider Addresses for TIFFANY LUCKEY
102 CANNERY ST
MARSHFIELD CLINIC GREENWOOD CENTER
GREENWOOD, WI 544379705
Phone: (715) 267-6600
Fax: (715) 267-6917
Type: Mailing
1011 E Spruce St
Suite 6, East Town Mall
Abbotsford, WI 544059647
Phone: (715) 223-3278
Type: Location
64, Gilman Road, Monmouth, Kennebec County, Maine, 04259, United States
GILMAN, WI 544330064
Phone: (715) 447-8293
Type: Mailing
Spruce Street, Abbotsford Centre, Abbotsford, Fraser Valley Regional District, British Columbia, V2S 2K1, Canada
SUITE 6, EAST TOWN MALL
ABBOTSFORD, WI 544059647
Phone: (715) 223-3278
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $81.
Total Amount is formed as General ($81) + Research ($0) + Ownership ($0) = $81.
Last reported payment date: 2024-03-14 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($81).
Total Amount
$81
General + Research + Ownership
Payments
1
Total payment records
General Amount
$81
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boehringer Ingelheim Pharmaceuticals, Inc. | $81 |
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: 2017-04-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170406000763 | I | Physician Assistant | WI | TBD |
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.
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 54437)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | WI | |
| Nurse Practitioner | WI | |
| Physician Assistant | WI | |
| Family Practice | WI | |
| Internal Medicine | WI | |
| Orthopedic Surgery | WI | |
| Nurse Practitioner | WI | |
| Internal Medicine, Pediatric Medicine | WI | |
| Emergency Medicine | WI | |
| Nurse Practitioner | WI |
Reviews
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