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SAMUEL JOLLEY PA-C
NPI 1336798222
Physician Assistant in Woodbury, MN

Active since September 04, 2019PECOS EnrolledAccepts Medicare Assignment
6025 LAKE RD STE 200, WOODBURY, MN 55125(651) 999-6800 Get Directions Write a Review

NPPES record last updated: August 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Samuel Jolley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL JOLLEY PA-C (NPI 1336798222) is an individual physician assistant in Woodbury, Minnesota, licensed in Minnesota (15239) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS, is affiliated with Allina United Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1336798222
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSAMUEL JOLLEYCredential: PA-C
Location Address6025 LAKE RD STE 200Woodbury, MN 55125-1710
Mailing Address3001 Metro Dr Ste 460Bloomington, MN 55425-1548 · (651) 999-6800 · Fax (651) 999-6970
Phone(651) 999-6800
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 4, 2019
Last NPPES UpdateAugust 20, 2025
NPPES CertifiedAugust 20, 2025
✔ NPI 1336798222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 15239
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
6025 LAKE RD STE 200, Woodbury, MN 55125
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.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 Jolley Pa-c 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 ID4385976182
PECOS Enrollment IDI20250807000989
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 3

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

Allina United Hospital

Acute Care Hospitals · Saint Paul, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240038
Location333 North Smith AvenueSaint Paul, MN 55102 · Ramsey County
Emergency services Birthing friendly

M Health Fairview St John's Hospital

Acute Care Hospitals · Maplewood, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240210
Location1575 Beam AvenueMaplewood, MN 55109 · Ramsey County
Emergency services Birthing friendly

M Health Fairview Woodwinds Hospital

Acute Care Hospitals · Woodbury, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240213
Location1925 Woodwinds DriveWoodbury, MN 55125 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55125 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
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
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.

MEKHA JOY KAROT PA-C
Physician Assistant
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800
NINA LEBRUN PA-C
Physician Assistant
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800
MRS. MARIA TERESA CHMIELEWSKI CNS
Clinical Nurse Specialist
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800
MINNESOTA ONCOLOGY HEMATOLOGY, PA
Internal Medicine (Hematology & Oncology)
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6982
TUCKER DOUGLAS RIENTS PA-C
Physician Assistant
6025 LAKE RD STE 200
SAINT PAUL, MN 55125
Washington County (651) 999-6800
MICHAEL G MEYER PA
Physician Assistant
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800
KELSEY JOY CARLSON PA-C
Physician Assistant
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800
HALLE FOSS MD
Urology
6025 LAKE RD STE 200
WOODBURY, MN 55125
Washington County (651) 999-6800

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 Jolley's NPI number?

The NPI number for Samuel Jolley is 1336798222. It was assigned to this individual provider in the NPPES registry on September 4, 2019.

Where is Samuel Jolley located?

Samuel Jolley practices at 6025 Lake Rd Ste 200, Woodbury, MN 55125. The listed phone number is (651) 999-6800.

What is Samuel Jolley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Samuel Jolley enrolled in Medicare?

Yes. Samuel Jolley 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 Jolley accept?

Health plans from HealthPartners list Samuel Jolley 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 Jolley affiliated with any hospitals?

According to CMS data, Samuel Jolley is affiliated with Allina United Hospital, M Health Fairview St John's Hospital and M Health Fairview Woodwinds Hospital.

When was this NPI record last updated?

The NPPES record for Samuel Jolley was last updated on August 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.