SAMUEL THOMAS GORACKE CNP
NPI 1144905159
Nurse Practitioner in St Louis Park, MN
About Samuel Thomas Goracke Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL THOMAS GORACKE CNP (NPI 1144905159) is an individual nurse practitioner in St Louis Park, Minnesota, licensed in Minnesota (10717) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS, is affiliated with University Medical Center-mesabi/ Mesaba Clinics, and maintains a secondary practice location in Saint Paul.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samuel Thomas Goracke Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
5Medicare enrollment records show Samuel Goracke reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Edina, MN 55435
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
Saint Croix Falls, WI 54024
- Reassigned Medicare billing, Wisconsin enrollment
- 453 clinicians in this Medicare group
Brooten, MN 56316
- Reassigned Medicare billing, Minnesota enrollment
- Also billed through NPI 1538178520 (Minnesota)
- 111 clinicians in this Medicare group
Grand Rapids, MN 55744
- Reassigned Medicare billing, Minnesota enrollment
- 555 clinicians in this Medicare group
Hibbing, MN 55746
- Reassigned Medicare billing, Minnesota enrollment
- 707 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Medical Center-Mesabi/ Mesaba Clinics
Acute Care Hospitals · Hibbing, MNGlacial Ridge Hospital
Critical Access Hospitals · Glenwood, MNSt Croix Regional Medical Center
Critical Access Hospitals · Saint Croix Falls, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55426 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ST LOUIS PARK, MN 55426
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel Goracke's NPI number?
The NPI number for Samuel Goracke is 1144905159. It was assigned to this individual provider in the NPPES registry on June 19, 2023.
Where is Samuel Goracke located?
Samuel Goracke practices at 6500 Excelsior Blvd, St Louis Park, MN 55426. The listed phone number is (320) 424-0570.
What is Samuel Goracke's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Samuel Goracke enrolled in Medicare?
Yes. Samuel Goracke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Samuel Goracke's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Goracke reassigns Medicare benefits to 5 organizations: Fairview Health Services (Edina, MN), St. Croix Regional Medical Center (Saint Croix Falls, WI), Glacial Ridge Hospital District (Brooten, MN), Grand Itasca Clinic And Hospital (Grand Rapids, MN) and Range Regional Health Services (Hibbing, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Goracke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Goracke accept?
Health plans from Sanford Health Plan list Samuel Goracke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Samuel Goracke affiliated with any hospitals?
According to CMS data, Samuel Goracke is affiliated with University Medical Center-Mesabi/ Mesaba Clinics, Glacial Ridge Hospital and St Croix Regional Medical Center.
When was this NPI record last updated?
The NPPES record for Samuel Goracke was last updated on September 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Samuel Thomas Goracke, CNP · NPI 1144905159
Nurse Practitioner physician in St Louis Park, Minnesota. Individual provider, active in the CMS NPPES registry since June 19, 2023.
## Identity
- **NPI:** 1144905159 (Entity type: Individual)
- **Enumerated:** June 19, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 10717 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 6500 EXCELSIOR BLVD, St Louis Park, MN 55426-4702
- **Phone:** (320) 424-0570
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Fairview Health Services (NPI 1699752915, Edina, MN); St. Croix Regional Medical Center (NPI 1043240922, Saint Croix Falls, WI); Glacial Ridge Hospital District (NPI 1255348223, Brooten, MN); Grand Itasca Clinic And Hospital (NPI 1669426631, Grand Rapids, MN); Range Regional Health Services (NPI 1356321699, Hibbing, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** September 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1144905159) · Data from the CMS NPPES public registry.