NPIMap

Individual provider Active NPI

Nicole Marie Stepan, PA-C

  • Medical Physician Assistant
  • Duluth, MN
National Provider Identifier
1972131282
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5530 Issued in WI
Practice address
1015 E 1St St BLDG A4Th
Duluth, MN 55805-2242
Phone
(218) 249-7940
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5530 WI Primary

Addresses

Primary practice location

1015 E 1St St BLDG A4Th
Duluth, MN 55805-2242

Mailing address

1015 E 1St St BLDG A4Th
Duluth, MN 55805-2242
Phone (218) 249-7940

Other names 1

  • Nicole Marie Grutkoski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211008002079 WI Practitioner - Physician Assistant 7416355243 Reassigns benefits to 1 organization
I20230104001893 MN Practitioner - Physician Assistant 7416355243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Aspirus Lake View Hospital Hospital, Two Harbors, MN, CCN 241308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5530WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Oct 18, 2021 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Oct 18, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 19, 2022 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 19, 2022 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1015 E 1st St
Bldg A4TH
Duluth, MN 55805
Phone (218) 249-7940

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: nicole.grutkoski2@slk.direct.slhduluth.com
  • Direct secure messaging: ngrutkoski534672@direct.emplifyhealth.org
  • Direct secure messaging: ngrutkoski237251@direct.aspirus.org

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 and National Provider Directory roles.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1972131282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E 1ST ST BLDG A4TH",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052242",
            "telephone_number": "218-249-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E 1ST ST BLDG A4TH",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052242",
            "telephone_number": "218-249-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPAN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "5530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GRUTKOSKI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.