CHARLES E SAMMIS DO
NPI 1376625103
Family Medicine in West Bend, WI

Q: What is Charles Sammis's NPI number?

The NPI number for Charles Sammis is 1376625103. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Q: What is Charles Sammis's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: Is Charles Sammis enrolled in Medicare?

No. Charles Sammis has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Charles Sammis was last updated on August 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 20, 2006Opted out of Medicare · through Jul 1, 2027

5595 COUNTY ROAD Z, WEST BEND, WI 53095(262) 339-3038(262) 674-1060 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 25, 2021, Feb 23, 2018, Feb 16, 2018 (3 updates tracked since 2018).

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About Charles E Sammis Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES E SAMMIS DO (NPI 1376625103) is an individual family medicine provider in West Bend, Wisconsin, licensed in Wisconsin (48218021) and active in the NPI registry since October 2006. He has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1376625103

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameCHARLES E SAMMISCredential: DO

Location Address5595 COUNTY ROAD ZWest Bend, WI 53095-9224

Mailing Address3545 Martha CtWest Bend, WI 53095-8792 · (262) 339-3033

Phone(262) 339-3038

Fax(262) 674-1060

Sole ProprietorNo

Enumeration DateOctober 20, 2006

Last NPPES UpdateAugust 25, 20213 updates tracked since enumeration

NPPES CertifiedAugust 25, 2021

✔ NPI 1376625103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 48218021

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5595 COUNTY ROAD Z, West Bend, WI 53095

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Other Identifiers 1

Other4209Internal Id-motor Vehicle Id

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Charles E Sammis Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2019 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2019

Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53095 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.

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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.

MRS. AIMEE HODOROWSKI OTR

Occupational Therapist