Charles E Sammis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

48218021 Issued in WI

Practice address

5595 County Road Z
West Bend, WI 53095-9224

Phone

(262) 339-3038

Fax

(262) 674-1060

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Patel Internal Medicine,P.C.

  • Internal Medicine Physician
  • Bethalto, IL
  • NPI 1134320096
  NPD (past)
• Saint Anthony'S Physician Group

  • Internal Medicine Physician
  • Alton, IL
  • NPI 1750497319

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1376625103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 MARTHA CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958792",
            "telephone_number": "262-339-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5595 COUNTY ROAD Z",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959224",
            "telephone_number": "262-339-3038",
            "fax_number": "262-674-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMIS",
        "first_name": "CHARLES",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "48218021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "4209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Nicole Salas, M.S. CCC-SLP
• Samaritan Fields CBRF LLC
• Samaritan Fields Rcac LLC
• Samaritan Health Center Subacute Unit
• Samaritan Nursing and Rehab LLC
• Warren W Samplaski, RPH
• Carlos R Sanabria, MD
• Cloetta Sanders
• Hadwat A. Sankari, LCSW
• Elaine Sapp, OTR/L

• Family Medicine Physician in West Bend, WI
• Providers in West Bend, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.