Nicholas James Pruett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10813 Issued in MN

Practice address

4801 W 81St St Ste 112
Bloomington, MN 55437-1111

Phone

(952) 345-3000

Fax

(952) 345-6789

NPI assigned

Aug 11, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

National Dizzy and Balance Center,LTD.Group PAC ID 7315983954, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

69.1 of 100Reported as group

Quality

39.3

Improvement activities

40

Cost

68.34

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• National Dizzy & Balance Center,LTD.

  • Physical Medicine & Rehabilitation Physician
  • Bloomington, MN
  • NPI 1023021938
  Medicare reassignment Care Compare group
• Advocate Urgent Care PLLC

  • Multi-Specialty Clinic/Center
  • Zimmerman, MN
  • NPI 1568245397
  Medicare reassignment
• Minnesota Neurosurgical Trauma Associates, PLLC

  • Neurological Surgery Physician
  • Coon Rapids, MN
  • NPI 1922241884
  Medicare reassignment
• MN UC Providers LTD

  • Urgent Care Clinic/Center
  • Hopkins, MN
  • NPI 1871265074
  Medicare reassignment
• MN UC Providers LTD

  • Urgent Care Clinic/Center
  • Maple Grove, MN
  • NPI 1891479945
  NPD
• Central Minnesota Neurosciences LTD

  • Neurological Surgery Physician
  • St. Cloud, MN
  • NPI 1972520773
  NPD (past)
• Lifespark Medical Group, PA

  • Geriatric Medicine (Family Medicine) Physician
  • St Louis Park, MN
  • NPI 1427551746
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1164737417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11850 Blackfoot St NW Ste 490",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332773",
            "country_code": "US",
            "telephone_number": "763-427-1137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 Cobblestone Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374578",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 101st Ave NE Ste 160",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554493403",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15700 37th Ave N Ste 150",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554463675",
            "country_code": "US",
            "telephone_number": "651-968-5201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7650 Currell Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551258209",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10813",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "10813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promet Inc
• Promise Care, Inc
• Amy J Prose, PT
• Proskin LLC
• Prosper Home Health and Transportation Services
• Patricia K Pryor
• Michael Jay Przeslawski, DC
• Psychiatric Pathways PLLC
• Psychotherapy - Psicoterapia
• Kelly Pudwill

• Physician Assistant in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.