SAM DYSART
NPI 1033080833
Counselor - Professional in Colorado Springs, CO

NPI Status: Active since September 15, 2025

Contact Information

12295 ORACLE BLVD STE 340
COLORADO SPRINGS, CO
ZIP 80921
Phone: (719) 203-1856

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Counselor
Professional
Opted-Out Medicare

About SAM DYSART

This page provides the complete NPI Profile along with additional information for Sam Dysart, a provider established in Colorado Springs, Colorado with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1033080833 assigned on September 2025. The practitioner's primary taxonomy code is 101YP2500X with license number LPC.0022721 (CO). The provider is registered as an individual and his NPI record was last updated January 2026.

NPI: 1033080833
Provider Name: SAM DYSART
Gender: Male
Entity Type: Individual
Location Address: 12295 ORACLE BLVD STE 340 COLORADO SPRINGS, CO 80921
Location Phone: (719) 203-1856
Mailing Address: 12295 ORACLE BLVD STE 340 COLORADO SPRINGS, CO 80921
Mailing Phone: (719) 203-1856
Is Sole Proprietor?: No
Enumeration Date: 09-15-2025
Last Update Date: 01-22-2026
Code Navigator

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Sam Dysart opted out of Medicare effective on 10-13-2025 until 10-13-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Counselor Professional
Taxonomy Code: 101YP2500X
Type: Behavioral Health & Social Service Providers
License No.: LPC.0022721
License State: CO

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Opted-Out of Medicare? Yes
Opt-Out Effective Date: 10-13-2025
Opt-Out End Date: 10-13-2027
Eligible to Order and Refer? No

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1033080833, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 0 → 0 0 → 0 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 6 + 3 + 0 + 8 + 0 + 8 + 6 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1033080833.