NPIMap

Individual provider Active NPI

Patrick Petrosky, PA-C

  • Physician Assistant
  • Stillwater, MN
National Provider Identifier
1144777137
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15463 Issued in MN
Practice address
1950 Curve Crest Blvd W Ste 100
Stillwater, MN 55082-6062
Phone
(651) 430-3800
Fax
(651) 430-3827
NPI assigned
Sep 7, 2016
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15463 MN Primary

Addresses

Primary practice location

1950 Curve Crest Blvd W Ste 100
Stillwater, MN 55082-6062

Mailing address

1950 Curve Crest Blvd W Ste 100
Stillwater, MN 55082-6062
Phone (651) 430-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105002404 MN Practitioner - Physician Assistant 4981194255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

280 Smith Ave N
Suite 600
Saint Paul, MN 55102-2446
Phone (651) 241-7246

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-4897

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15463MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Sep 15, 2025 Accepting new patients
Allina Health System Current Accepting new patients
North Memorial Health Care CurrentSince Oct 1, 2025 Accepting new patients
North Memorial Health Care CurrentSince Oct 1, 2025 Accepting new patients
North Memorial Health Care Current Accepting new patients
Allina Health System CurrentSince Sep 15, 2025 Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

305 E Nicollet Blvd
Ste 372
Burnsville, MN 55337
Phone (952) 460-4130

7270 Forestview Ln N
Ste 100
Maple Grove, MN 55369

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

3366 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 287-5000

280 Smith Ave N
Ste 600
Saint Paul, MN 55102
Phone (651) 241-6550

1950 Curve Crest Blvd W
Ste 100
Stillwater, MN 55082
Phone (651) 275-0500

Interoperability endpoints

  • Direct secure messaging: ppetrosky223256@direct.northmemorial.com

Organizations & group practices 7

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

Hospital & facility affiliations 5

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1144777137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CURVE CREST BLVD W STE 100",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826062",
            "telephone_number": "651-430-3800",
            "fax_number": "651-430-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CURVE CREST BLVD W STE 100",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826062",
            "telephone_number": "651-430-3800",
            "fax_number": "651-430-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.