Active NPI
Kassandra Marie Sakura Samuel
- Surgery Physician
- Madison, WI
National Provider Identifier
1831616911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 87446
- Practice address
- 600 Highland Ave
Madison, WI 53792-0001 - Phone
- (303) 724-2680
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 87446 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792-0001
Mailing address
600 Highland Ave
Madison, WI 53792-0001
Phone (303) 724-2680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210813001338 | CO | Order and Referring Only - General Surgery | 3072917996 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1831616911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "303-724-2680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "303-724-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "KASSANDRA",
"middle_name": "MARIE SAKURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "87446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.