1. Home
  2. Directory
  3. Minnesota
  4. St Louis Park
  5. Nurse Practitioner
  6. NPI Profile

SAMUEL THOMAS GORACKE CNP
NPI 1144905159
Nurse Practitioner in St Louis Park, MN

Active since June 19, 2023PECOS EnrolledAccepts Medicare Assignment
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426(320) 424-0570 Get Directions Write a Review

NPPES record last updated: September 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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 Glacial Ridge Hospital, and maintains a secondary practice location in Saint Paul.

NPPES Registry Identity

NPI1144905159
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameSAMUEL THOMAS GORACKECredential: CNP
Location Address6500 EXCELSIOR BLVDSt Louis Park, MN 55426-4702
Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
Phone(320) 424-0570
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJune 19, 2023
Last NPPES UpdateSeptember 27, 2023
NPPES CertifiedSeptember 27, 2023
✔ NPI 1144905159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MN · 10717
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedInternal MedicineTaxonomy 207R00000X · License 00000000 (MN)
6500 EXCELSIOR BLVD, St Louis Park, MN 55426
Open in Google Maps ↗

Secondary Practice Location 1

Location 1640 Jackson StSaint Paul, MN 55101-2502 · Phone (320) 424-0570

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID143674440
PECOS Enrollment IDI20230920001693, I20250404000901
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Glacial Ridge Hospital

Critical Access Hospitals · Glenwood, MN
OwnershipGovernment - Hospital District or Authority
CMS Certification Number241376
Location10 4th Avenue SoutheastGlenwood, MN 56334 · Pope County
Emergency services

St Croix Regional Medical Center

Critical Access Hospitals · Saint Croix Falls, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521337
Location235 E State StreetSaint Croix Falls, WI 54024 · Polk County
Emergency services

Physician 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.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

NANCY COLE NELSON M.D.
Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3282
DR. KATIE LYNN ANDRINAS MD, MPH
Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3282
CARA HOULE MD
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-5000
JANET GRAYSON MD
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6600
JEFFREY J SHULTZ
Internal Medicine (Cardiovascular Disease)
6500 EXCELSIOR BLVD, PARK NICOLLET CLINIC - HEART & VASCULAR CENTER
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3246
MARY BETH JOHNSON OTR/L
Occupational Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6087
MARY KATHERINE KOSANDA P.T.
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6014
JENNIFER A DEUTZ P.T.
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-5900

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.

What insurance does Samuel Goracke accept?

Health plans from Medica 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 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 2 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.