Jack Woodworth Sample II, MD
NPI 1093393944ActiveIndividual· Surgery· Rochester, MN
Surgery (MD) in Rochester, Minnesota, trained at University of Toledo College of Medicine (class of 2021). Enrolled in Medicare as practitioner - general surgery.
Overview
| NPI | 1093393944 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Mar 31, 2021 |
| Last updated in NPPES | Aug 11, 2022 |
| Certified by provider | Aug 11, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | 72034 | MN |
| Surgery | 208600000X | 31589 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - General Surgery (MN) |
|---|
Education and affiliations
| Medical school | University of Toledo College of Medicine |
|---|---|
| Graduation year | 2021 |
| Medicare specialty | General Surgery |
Medical group
- Mayo ClinicRochester, MN · 4,956 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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