SAM DYSART
NPI 1033080833
Counselor - Professional in Colorado Springs, CO
About Sam Dysart NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAM DYSART (NPI 1033080833) is an individual professional provider in Colorado Springs, Colorado, licensed in Colorado (LPC.0022721) and active in the NPI registry since September 2025. He has opted out of Medicare through October 13, 2027.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Sam Dysart has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 13, 2025 through October 13, 2027.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COLORADO SPRINGS, CO 80921
COLORADO SPRINGS, CO 80921
COLORADO SPRINGS, CO 80921
COLORADO SPRINGS, CO 80921
COLORADO SPRINGS, CO 80921
COLORADO SPRINGS, CO 80921
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sam Dysart's NPI number?
The NPI number for Sam Dysart is 1033080833. It was assigned to this individual provider in the NPPES registry on September 15, 2025.
Where is Sam Dysart located?
Sam Dysart practices at 12295 Oracle Blvd Ste 340, Colorado Springs, CO 80921. The listed phone number is (719) 203-1856.
What is Sam Dysart's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Sam Dysart enrolled in Medicare?
No. Sam Dysart has opted out of Medicare through October 13, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Sam Dysart was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sam Dysart · NPI 1033080833
Professional provider in Colorado Springs, Colorado. Individual provider, active in the CMS NPPES registry since September 15, 2025.
## Identity
- **NPI:** 1033080833 (Entity type: Individual)
- **Enumerated:** September 15, 2025
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC.0022721 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 12295 ORACLE BLVD STE 340, Colorado Springs, CO 80921-3902
- **Phone:** (719) 203-1856
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through October 13, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** January 22, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1033080833) · Data from the CMS NPPES public registry.