Samuel Thomas Goracke, CNP is a medicare enrolled "Nurse Practitioner" physician in St Louis Park, Minnesota. He graduated from medical school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice St. Croix Regional Medical Center and 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
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1144905159.
Physician's Profile
| Full Name | Samuel Thomas Goracke |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 6500 Excelsior Blvd, St Louis Park, Minnesota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Samuel Thomas Goracke graduated from medical school in 2023
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: I20250404000901
Medical Identifiers
Medical identifiers for Samuel Thomas Goracke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1144905159 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 00000000 (Minnesota) | Secondary |
| 363L00000X | Nurse Practitioner | 10717 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| St. Croix Regional Medical Center | 9335032184 | 109 |
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 Name | St. Croix Regional Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043240922 PECOS PAC ID: 9335032184 Enrollment ID: O20040205000217 |
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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 Address | Practice 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 |
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