BANKOLE A. SAMUEL (M.D.) – Surgery Physician, NPI 1376838243
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,028 GENERAL SURGERY in MA
Provider Addresses for BANKOLE A. SAMUEL (M.D.)
102 Shore Dr Ste 303
Worcester, MA 016053154
Phone: (508) 856-0458
Fax: (866) 217-1166
Type: Location
85 LINCOLN STREET
410
FRAMINGHAM, MA 01702
Phone: (508) 820-1650
Fax: (508) 872-2796
Type: Mailing
813 Southbridge St
Auburn, MA 015011323
Phone: (508) 832-5842
Type: Location
104 Leominster Rd
Sterling, MA 015642114
Phone: (978) 422-7774
Type: Location
100 Leominster Rd Ste 1
Sterling, MA 015642156
Phone: (978) 422-7774
Fax: (978) 422-9089
Type: Location
102 Shore Dr Ste 403
Worcester, MA 016053154
Phone: (508) 852-5230
Fax: (508) 854-1402
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $2,082.
Total Amount is formed as General ($2,082) + Research ($0) + Ownership ($0) = $2,082.
Last reported payment date: 2024-07-02 • Largest payer in this snapshot: Medtronic, Inc. ($1,407).
Total Amount
$2,082
General + Research + Ownership
Payments
3
Total payment records
General Amount
$2,082
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $1,407 |
| Bolder Surgical, LLC | $675 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-08-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170821000502 | I | General Surgery | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 44 | 44 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 36 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 21 | 14 | $0 |
Insurance plans in this area (ZIP 01605)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MA | |
| Physician Assistant | MA | |
| Nurse Practitioner | NH | |
| Internal Medicine, Sports Medicine | MA | |
| G A S T R O E N T E R O L O G Y | MA | |
| Family Practice, Obstetrics/Gynecology | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| Physician Assistant | MA | |
| Physician Assistant | MA | |
| - | MA |
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