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

Individual provider Physician Assistant · NPI 1760144703

Samantha Bukolt, PA-C is a Physician Assistant in Minneapolis, Minnesota. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2021
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

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone: (612) 813-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 E 77th St, New York, NY 10075-1850 — (212) 434-2000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)

Record details

NPI number1760144703
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 7, 2021
Last updated in NPPESDecember 8, 2024
Certification dateDecember 8, 2024

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