SUSAN SAMPLE NP
NPI 1316496565
Nurse Practitioner - Psychiatric/Mental Health in Oshkosh, WI
About Susan Sample Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSAN SAMPLE NP (NPI 1316496565) is an individual psychiatric/mental health provider in Oshkosh, Wisconsin, licensed in Wisconsin (7300-33) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Susan Sample Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Susan Sample reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 4,609 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OSHKOSH, WI 54904
OSHKOSH, WI 54904
OSHKOSH, WI 54904
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Susan Sample's NPI number?
The NPI number for Susan Sample is 1316496565. It was assigned to this individual provider in the NPPES registry on September 29, 2016.
Where is Susan Sample located?
Susan Sample practices at 700 N Westhaven Dr, Oshkosh, WI 54904. The listed phone number is (920) 456-2030.
What is Susan Sample's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Susan Sample enrolled in Medicare?
Yes. Susan Sample is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Susan Sample's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Susan Sample reassigns Medicare benefits to Aurora Medical Group, Inc. (Sheboygan, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Sample's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Susan Sample accept?
Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Susan Sample as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Susan Sample was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Susan Sample, NP · NPI 1316496565
Psychiatric/Mental Health physician in Oshkosh, Wisconsin. Individual provider, active in the CMS NPPES registry since September 29, 2016.
## Identity
- **NPI:** 1316496565 (Entity type: Individual)
- **Enumerated:** September 29, 2016
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 7300-33 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 700 N WESTHAVEN DR, Oshkosh, WI 54904
- **Phone:** (920) 456-2030 · **Fax:** (920) 456-2025
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Aurora Medical Group, Inc. (NPI 1174670244, Sheboygan, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** November 21, 2025
- **Other identifiers:** Medicaid 100062248 (WI); Medicaid 100063103 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1316496565) · Data from the CMS NPPES public registry.