SAMUEL O. POORE (M.D., PH.D.) – Plastic Surgery Physician, NPI 1760425433
Plastic Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
125 PLASTIC AND RECONSTRUCTIVE SURGERY in WI
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Provider Addresses for SAMUEL O. POORE (M.D., PH.D.)
7974, UW Health Court, Discovery Springs, City of Middleton, Dane County, Wisconsin, 53562, United States
MIDDLETON, WI 535625531
Phone:
Type: Mailing
University Hospital Outpatient Pharmacy, 600, Highland Avenue, Madison, Dane County, Wisconsin, 53705-2221, United States
MADISON, WI 537920001
Phone: (608) 263-7502
Fax: (608) 265-9695
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2022-01-11
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20100713000694 | I | Plastic And Reconstructive Surgery | WI | TBD |
| I20220111001413 | I | Plastic And Reconstructive Surgery | IL | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 20 | 19 | $0 |
Insurance plans in this area (ZIP 53562)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| - | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| Family Practice | WI | |
| - | WI | |
| - | WI | |
| - | WI | |
| Endocrinology, Internal Medicine | WI | |
| Medical Oncology, Hematology/Oncology | CA |
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