Nicholas James Pruett (NPI# 1164737417, PAC ID# 0648468892) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1164737417 |
| PAC ID by PECOS | 0648468892 |
| Professional Enrollment ID | I20110103000761 |
| Full Name | Nicholas James Pruett |
| Organization Legal Name | MINNESOTA NEUROSURGICAL TRAUMA ASSOCIATES, PLLC |
| Address |
11850 Blackfoot Nwst Suite 490 Coon Rapids MN 55433-2773 |
| Phone Number | 7634271137 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6305998980 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240115 | MERCY HOSPITAL |
| 240001 | NORTH MEMORIAL MEDICAL CENTER |
| 240057 | ABBOTT NORTHWESTERN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 | 7634271137 | MINNESOTA NEUROSURGICAL TRAUMA ASSOCIATES, PLLC |
| 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 | METROPOLITAN NEUROSURGERY PA | |
| 9600 Upland N Ln, Suite 160, Maple Grove, MN 55369-4302 | 7634271137 | METROPOLITAN NEUROSURGERY PA |
| 800 E 28th St, Suite 304, Minneapolis, MN 55407-3723 | 7634271137 | METROPOLITAN NEUROSURGERY PA |
| 2855 Campus Dr, Suite 610, Plymouth, MN 55441-2683 | 7634271137 | METROPOLITAN NEUROSURGERY PA |
| 3300 Oakdale N Ave, Robbinsdale, MN 55422-2926 | 7634271137 | METROPOLITAN NEUROSURGERY PA |
| Organization Legal Name | MINNESOTA NEUROSURGICAL TRAUMA ASSOCIATES, PLLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alyssa J Schlenker | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Robert M Roach | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Joseph R Kapurch Ii | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Ruby M Bowers | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kyle S Nelson | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Tammy J Estrem | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Timothy James Kovanda | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Hart P Garner | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kayla Marie Heyn | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kyle M Uittenbogaard | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Street Address |
11850 BLACKFOOT NWST SUITE 490 |
| City | COON RAPIDS |
| State | MN |
| Zip | 55433-2773 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alyssa J Schlenker | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Robert M Roach | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Joseph R Kapurch Ii | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Ruby M Bowers | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kyle S Nelson | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Tammy J Estrem | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Timothy James Kovanda | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Hart P Garner | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kayla Marie Heyn | Physician Assistant | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Kyle M Uittenbogaard | Neurosurgery | Minnesota Neurosurgical Trauma Associates, Pllc | 11850 Blackfoot Nwst, Suite 490, Coon Rapids, MN 55433-2773 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kyle D Traynor | Chiropractic | Waypoint Minnesota PC | 3183 Northdale Blvd Nw, Suite 103, Coon Rapids, MN 55433-1756 |
| Craig A Schadow | Chiropractic | 3818 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2517 | |
| Stephanie Rae Walvatne | Nurse Practitioner | 3887 Coon Rapids Nwblvd, Coon Rapids, MN 55433-2518 | |
| George A Haikel | Urology | 3879 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | |
| Melanie A Ferguson | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 |
| Mark D Mcmillan | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 4050 Coon Rapids Nwblvd, Coon Rapids, MN 55433-2522 |
| John A Kosiak | Radiation Oncology | Minneapolis Radiation Oncology Pa | 4030 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 |
| Joyce S Stewart | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 |
| Amber Galarowicz | Internal Medicine | Allina Health System | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 |
| Michael A Erickson | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 |
| Find all physicians in zip 55433 | |||
| City | COON RAPIDS |
| Zip Code | 55433 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | COON RAPIDS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Nicholas James Pruett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.