Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Samuel Carl Gisselman, PA-C

Individual provider Physician Assistant · NPI 1972492114

Mr. Samuel Carl Gisselman, PA-C is a Physician Assistant in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2025.

Licensed in
MN
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1801 Nicollet Ave
Minneapolis, MN 55403-3791
Phone: (612) 823-2947
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15416 (MN)

Record details

NPI number1972492114
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 1, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025

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