SAMANTHA BUKOLT PA-C
NPI 1760144703
Physician Assistant in Minneapolis, MN

Q: What is Samantha Bukolt's NPI number?

The NPI number for Samantha Bukolt is 1760144703. It was assigned to this individual provider in the NPPES registry on October 7, 2021.

Q: What is Samantha Bukolt's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samantha Bukolt was last updated on December 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.

Active since October 07, 2021PECOS Enrolled

91.25/100

CMS Quality Rating

2525 CHICAGO AVE, MINNEAPOLIS, MN 55404(612) 813-6000 Get Directions Write a Review

NPPES record last updated: December 8, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 8, 2024, Oct 13, 2021, Oct 7, 2021 (3 updates tracked since 2021).

On this page

About Samantha Bukolt Pa-c NPPES

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

SAMANTHA BUKOLT PA-C (NPI 1760144703) is an individual physician assistant in Minneapolis, Minnesota and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760144703

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSAMANTHA BUKOLTCredential: PA-C

Location Address2525 CHICAGO AVEMinneapolis, MN 55404-4518

Mailing Address100 E 77th StNew York, NY 10075-1850

Phone(612) 813-6000

Sole ProprietorNo

Enumeration DateOctober 7, 2021

Last NPPES UpdateDecember 8, 20243 updates tracked since enumeration

NPPES CertifiedDecember 8, 2024

✔ NPI 1760144703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

2525 CHICAGO AVE, Minneapolis, MN 55404

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, 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 (PECOS)

Samantha Bukolt Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

23 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55404 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.92

Promoting Interoperability

91.67

Improvement Activities

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.

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