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

Individual provider Physician Assistant · NPI 1336798222

Samuel Jolley, PA-C is a Physician Assistant in Woodbury, Minnesota. Qualified in 2019, 7 years ago. Practices with Minnesota Urology, PA, a 82-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
7
Licensed in
MN
In the registry since
2019
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

6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone: (651) 999-6800
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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 15239 (MN)

Record details

NPI number1336798222
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 4, 2019
Last updated in NPPESAugust 20, 2025
Certification dateAugust 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Minnesota Urology, Pa — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Woodbury