Samuel Thomas Goracke, CNP - Medicare Nurse Practitioner in St Louis Park, MN

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Samuel Thomas Goracke, CNP is a medicare enrolled "Nurse Practitioner" physician in St Louis Park, Minnesota. His current practice location is 6500 Excelsior Blvd, St Louis Park, Minnesota. You can reach out to his office (for appointments etc.) via phone at (320) 424-0570.

Samuel Thomas Goracke is licensed to practice in Minnesota (license number 10717) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1144905159.

Contact Information

Samuel Thomas Goracke, CNP
6500 Excelsior Blvd,
St Louis Park, MN 55426-4702
(320) 424-0570
Not Available

Map and Direction




Physician's Profile

Full NameSamuel Thomas Goracke
GenderMale
SpecialityNurse Practitioner
Location6500 Excelsior Blvd, St Louis Park, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1144905159
  • Provider Enumeration Date: 06/19/2023
  • Last Update Date: 09/27/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0143674440
  • Enrollment ID: I20230920001693

Medical Identifiers

Medical identifiers for Samuel Thomas Goracke such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144905159NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 00000000 (Minnesota)Secondary
363L00000XNurse Practitioner 10717 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Thomas Goracke allows following entities to bill medicare on his behalf.
Entity NamePark Nicollet Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780621904
PECOS PAC ID: 7911819438
Enrollment ID: O20031104000046
Entity NameGroup Health Plan Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710924683
PECOS PAC ID: 1759293954
Enrollment ID: O20031105000417

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Thomas Goracke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samuel Thomas Goracke, CNP
8170 33rd Ave S # Ms 21110q,
Bloomington, MN 55425-4516

Ph: () -		Samuel Thomas Goracke, CNP
6500 Excelsior Blvd,
St Louis Park, MN 55426-4702

Ph: (320) 424-0570

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.