Samuel Gowan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15741 Issued in MN

Practice address

2945 Hazelwood St Ste 200
Maplewood, MN 55109-1243

Phone

(651) 232-7800

NPI assigned

Dec 23, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Fairview Specialty Services

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1588543862
  Medicare reassignment
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1437014362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091243",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWAN",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-23",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Justin Gomes III, DDS
• Saad Jameel Gondal, MD
• Good Start Living LLC
• Kathryn Hanson Goralski, MD
• Nicole Gornowicz, LPCC, ATR
• Ashley Kay Grace, FNP
• Caprice Dorlee Graham, LADC, BCCR
• Grand St Paul CVS LLC
• Thomas E Grande, MD
• Nancy C Grandt, CNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.