Individual provider Active NPI

Samantha Jo Graf, DNP, FNP-BC

  • Family Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1053287490
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13563 Issued in MN
Practice address
820 Lilac Dr N Ste 140
Golden Valley, MN 55422-4791
Phone
(763) 465-0500
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13563 MN Primary

Addresses

Primary practice location

820 Lilac Dr N Ste 140
Golden Valley, MN 55422-4791

Mailing address

11237 President Dr NE
Blaine, MN 55434-1774
Phone (612) 805-8774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260318002598 MN Practitioner - Nurse Practitioner 6406330471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11237 President Dr NE
Blaine, MN 55434-1774

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13563MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aeris Medical Group PLLC CurrentSince Feb 3, 2026 Accepting new patients

Locations

820 Lilac Dr N
Ste 140
Minneapolis, MN 55422
Phone (763) 465-0500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1053287490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11237 PRESIDENT DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341774",
            "telephone_number": "612-805-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N STE 140",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224791",
            "telephone_number": "763-465-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAF",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.