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JACEK BERNARD WYSOCKI LMFT
NPI 1104165224
Marriage & Family Therapist in Los Angeles, CA

Active since February 08, 2013PECOS Enrolled
1031 W 34TH ST STE 500, LOS ANGELES, CA 90089(213) 821-6500 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 8, 2020, Nov 19, 2017 (2 updates tracked since 2017).

About Jacek Bernard Wysocki Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACEK BERNARD WYSOCKI LMFT (NPI 1104165224) is an individual marriage & family therapist in Los Angeles, California, licensed in California (LMFT101799) and active in the NPI registry since February 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104165224
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameJACEK BERNARD WYSOCKICredential: LMFT
Location Address1031 W 34TH ST STE 500Los Angeles, CA 90089-2501
Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (213) 821-6500
Phone(213) 821-6500
Sole ProprietorNo
Enumeration DateFebruary 8, 2013
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2020
✔ NPI 1104165224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · LMFT101799
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1031 W 34TH ST STE 500, Los Angeles, CA 90089
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacek Bernard Wysocki Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacek Wysocki reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Usc Care Medical Group, Inc
5.6 mi
General Practice
1520 SAN PABLO ST
Los Angeles, CA 90033
  • Reassigned Medicare billing, California enrollment
  • 2,445 clinicians in this Medicare group
NPI 1902846306 (323) 442-5955

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS CHRISTINA MOHAJERANI PSYD
Psychologist (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
MING-CHE TU PSYD
Psychologist (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
DR. SHANNON DUNN PHD, LCSW
Social Worker (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
DR. SEPEHR AZIZ DO
Psychiatry & Neurology (Psychiatry)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 764-2800
SARAH RACHEL RUFFMAN
Social Worker (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
DR. CASSANDRA PENTZIEN PHD
Psychologist (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
MR. ANDREW CHEN
Marriage & Family Therapist
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500
KATHRYN ELIZABETH SMITH PH.D.
Psychologist (Clinical)
1031 W 34TH ST STE 500
LOS ANGELES, CA 90089
Los Angeles County (213) 821-6500

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 Jacek Wysocki's NPI number?

The NPI number for Jacek Wysocki is 1104165224. It was assigned to this individual provider in the NPPES registry on February 8, 2013.

Where is Jacek Wysocki located?

Jacek Wysocki practices at 1031 W 34th St Ste 500, Los Angeles, CA 90089. The listed phone number is (213) 821-6500.

What is Jacek Wysocki's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Jacek Wysocki enrolled in Medicare?

Yes. Jacek Wysocki is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacek Wysocki's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacek Wysocki reassigns Medicare benefits to Usc Care Medical Group, Inc (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacek Wysocki's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacek Wysocki was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.