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Nicholas Sample , CAA

Anesthesiologist Assistant โ€ข La Crosse, WI

Active NPI 1205236031 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

1836 South Ave
La Crosse, WI 546015429

Call 6087827300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1836 South Ave

La Crosse, WI 546015429

Telephone 6087827300
Organization at the Same NPPES Address or Phone
Gundersen Clinic Ltd Facility NPI 1851343115

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Wildwood, MO. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Gundersen Lutheran Medical Center Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2021

Medicare patients

106 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $1,136 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $868 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Years since graduation

5 years (graduated 2021)

CMS Doctors and Clinicians data list 2021 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Nicholas Sample has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in La Crosse and Wisconsin

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Close to the middle for clinicians listed under Anesthesiologist Assistant in La Crosse, WI (2024, 16 clinicians with data). Median for this group: 24. Middle half: 16 to 27.

Close to the middle for clinicians listed under Anesthesiologist Assistant in Wisconsin (2024, 133 clinicians with data). Median for this group: 28. Middle half: 16 to 55.

Medicare-allowed amount

A lower Medicare-allowed amount than 65% of clinicians listed under Anesthesiologist Assistant in La Crosse, WI (2024, 16 clinicians with data). Median for this group: $1,275. Middle half: $885 to $2,013.

A lower Medicare-allowed amount than 75% of clinicians listed under Anesthesiologist Assistant in Wisconsin (2024, 133 clinicians with data). Median for this group: $2,310. Middle half: $1,245 to $4,244.

Paid by Medicare

A lower Medicare payment amount than 65% of clinicians listed under Anesthesiologist Assistant in La Crosse, WI (2024, 16 clinicians with data). Median for this group: $988. Middle half: $696 to $1,566.

A lower Medicare payment amount than 75% of clinicians listed under Anesthesiologist Assistant in Wisconsin (2024, 133 clinicians with data). Median for this group: $1,796. Middle half: $992 to $3,236.

25 active clinicians are listed under Anesthesiologist Assistant with a practice address in La Crosse, WI (264 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in La Crosse

0% of these 25 clinicians have the CMS telehealth indicator.

88% of these 25 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2021โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2022โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
00142 Anesthesia for lens surgery
23 23 $1097.74 $49.41

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-10-29
Anesthesiologist Assistant Primary Specialty

NUCC Taxonomy Code: 367H00000X

License # reported to NPPES WI 195-17

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

Specialist/Technologist - Athletic Trainer

NUCC Taxonomy Code: 2255A2300X

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - ANESTHESIOLOGY ASSISTANT

Medicare Enrollment ID

I20211105000090

Enrollment State Jurisdiction

WI

PECOS Control ID

4284023607

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Gundersen Lutheran Medical Center Inc

1910 S Ave, La Crosse, WI 546015467

Phone: 6087827300

Secondary Practice Locations

537 Crown Pointe Estates Ct

Wildwood, MO 630212012

Phone: 3149715488

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

30 listed
Grace Abicht

Nurse Anesthetist, Certified Registered

NPI 1003651555
Dr. Ivy Andersen , MD

Psychiatry & Neurology - Sleep Medicine

NPI 1013064997

Doctor of Medicine (M.D.)

Dr. Emily Bresette , DO

Internal Medicine

NPI 1013302173

Doctor of Osteopathic Medicine (D.O.)

Whitney Brusich , PA-C

Physician Assistant - Medical

NPI 1013430073

Physician Assistant (Certified)

Dr. Kelly Carothers , MD

Emergency Medicine

NPI 1003936857

Doctor of Medicine (M.D.)

NPI 1013414929

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
๐Ÿ“
Updated Practice Location October 29, 2021

Registered at 1836 SOUTH AVE, LA CROSSE, WI 546015429 (Tel: 6087827300)

๐Ÿ“
Updated Business Mailing Address October 29, 2021

Registered at 1836 SOUTH AVE, LA CROSSE, WI 546015429 (Tel: 6087827300)

๐Ÿ‘ค
Provider Name / Credentials Updated October 29, 2021

Recorded as NICHOLAS SAMPLE, CAA

๐Ÿ“
Updated Practice Location December 16, 2019

Registered at 537 CROWN POINTE ESTATES CT, WILDWOOD, MO 630212012 (Tel: 3149715488)

๐Ÿ“
Updated Business Mailing Address December 16, 2019

Registered at 537 CROWN POINTE ESTATES CT, WILDWOOD, MO 630212012 (Tel: 3149715488)

โœ…
NPI Profile Active August 29, 2014

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) August 29, 2014

Registered at 1231 SW 3RD AVE APT 211, GAINESVILLE, FL 326016304 (Tel: 3149715548)

๐Ÿ“
Business Mailing Address (Initial Record) August 29, 2014

Registered at 1231 SW 3RD AVE APT 211, GAINESVILLE, FL 326016304 (Tel: 3149715548)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) August 29, 2014

Recorded as NICHOLAS SAMPLE

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2014

Specialist/Technologist

๐ŸŸข
Initial NPI Registration & Enumeration August 29, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1205236031
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 29, 2014
Last Update: October 29, 2021
Sole Proprietor: No

Other Anesthesiologist Assistants in La Crosse

All Anesthesiologist Assistants in La Crosse

Mailing Address

1836 South Ave

La Crosse, WI 546015429

Phone: 6087827300

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.