SUSAN SAMPLE NP
NPI 1316496565
Nurse Practitioner - Psychiatric/Mental Health in Oshkosh, WI

Active since September 29, 2016PECOS EnrolledAccepts Medicare Assignment
700 N WESTHAVEN DR, OSHKOSH, WI 54904(920) 456-2030(920) 456-2025 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 21, 2025, Nov 18, 2021, Jul 24, 2018 and 2 more (5 updates tracked since 2016).

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

NPI1316496565
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSUSAN SAMPLECredential: NP
Location Address700 N WESTHAVEN DROshkosh, WI 54904
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Fax(920) 456-2025
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateSeptember 29, 2016
Last NPPES UpdateNovember 21, 20255 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
NPI 1316496565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in WI · 7300-33
Also ListedNurse PractitionerTaxonomy 363L00000X · License 7300 (WI)
700 N WESTHAVEN DR, Oshkosh, WI 54904

Other Identifiers 2

Medicaid100062248WI
Medicaid100063103WI

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID345538666
PECOS Enrollment IDI20161019000740
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
191 services71 patients

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.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Social Worker (Clinical)
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Psychiatry & Neurology (Psychiatry)
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Clinical Neuropsychologist
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Social Worker
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Pain Medicine (Interventional Pain Medicine)
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Nurse Practitioner (Psychiatric/Mental Health)
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Nurse Practitioner (Psychiatric/Mental Health)
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Counselor (Professional)
700 N WESTHAVEN DR
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.

What insurance does Susan Sample accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Medica 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 with the weekly NPPES data releases published by CMS.