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KASSANDRA MARIE SAKURA SAMUEL
NPI 1831616911
Surgery in Aurora, CO

Active since August 29, 2017PECOS Enrolled
12631 E 17TH AVE RM 5403, AURORA, CO 80045(303) 724-2680 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 19, 2021, Aug 29, 2017 (2 updates tracked since 2017).

About Kassandra Marie Sakura Samuel NPPES

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

KASSANDRA MARIE SAKURA SAMUEL (NPI 1831616911) is an individual surgery provider in Aurora, Colorado, licensed in Colorado (DR.0071270) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1831616911
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameKASSANDRA MARIE SAKURA SAMUEL
Location Address12631 E 17TH AVE RM 5403Aurora, CO 80045-2527
Mailing Address12631 E 17th Ave Rm 5403Aurora, CO 80045-2527 · (303) 724-2680
Phone(303) 724-2680
Sole ProprietorNo
Enumeration DateAugust 29, 2017
Last NPPES UpdateJune 30, 20262 updates tracked since enumeration
NPPES CertifiedJune 30, 2026
✔ NPI 1831616911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in CO · DR.0071270
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
12631 E 17TH AVE RM 5403, Aurora, CO 80045
Open in Google Maps ↗

Secondary Practice Location 1

Location 1240 E Huron St Ste 1-200Chicago, IL 60611-2909 · Phone (312) 503-7975

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kassandra Marie Sakura Samuel is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80045 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
Most-billed visit code 99213
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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAX KREVALIN MD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE RM 5403
AURORA, CO 80045
Adams County (303) 724-2680
DR. ALI TAREQ LILO MD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE RM 5403
AURORA, CO 80045
Adams County (303) 724-2680

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 Kassandra Samuel's NPI number?

The NPI number for Kassandra Samuel is 1831616911. It was assigned to this individual provider in the NPPES registry on August 29, 2017.

Where is Kassandra Samuel located?

Kassandra Samuel practices at 12631 E 17th Ave Rm 5403, Aurora, CO 80045. The listed phone number is (303) 724-2680.

What is Kassandra Samuel's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Kassandra Samuel enrolled in Medicare?

Yes. Kassandra Samuel is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kassandra Samuel was last updated on June 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.