Samuel Thomas Goracke, CNP is a
Nurse Practitioner physician based in St Louis Park, Minnesota. Samuel Thomas Goracke is licensed to practice in Minnesota (license number 10717) and his current practice location is 6500 Excelsior Blvd, St Louis Park, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(320) 424-0570.
NPI number for Samuel Thomas Goracke is 1144905159 and his current mailing address is 8170 33rd Ave S # Ms 21110q, Bloomington, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144905159.
Physician's Profile
| Full Name | Samuel Thomas Goracke |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner |
|---|
| Location | 6500 Excelsior Blvd, St Louis Park, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1144905159
- Provider Enumeration Date: 06/19/2023
- Last Update Date: 09/27/2023
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 |
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
NOT enrolled with medicare and thus cannot 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 |
Reviews and Comments