DR. LUIS SAN ROMAN LCPC
NPI 1124480595
Counselor - Professional in Lake Bluff, IL
About Dr. Luis San Roman Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. LUIS SAN ROMAN LCPC (NPI 1124480595) is an individual professional provider in Lake Bluff, Illinois, licensed in Illinois (18012203) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Luis San Roman Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Luis San Roman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lake Bluff, IL 60044
- Reassigned Medicare billing, Illinois enrollment
- 10 clinicians in this Medicare group
Rolling Meadows, IL 60008
- Reassigned Medicare billing, Illinois enrollment
- 2 clinicians in this Medicare group
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 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Luis San Roman's NPI number?
The NPI number for Luis San Roman is 1124480595. It was assigned to this individual provider in the NPPES registry on March 24, 2016.
Where is Luis San Roman located?
Luis San Roman practices at 100 N Waukegan Rd Ste 204, Lake Bluff, IL 60044. The listed phone number is (847) 821-9346.
What is Luis San Roman's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Luis San Roman enrolled in Medicare?
Yes. Luis San Roman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Luis San Roman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Luis San Roman reassigns Medicare benefits to 2 organizations: White Stone Partners LLC (Lake Bluff, IL) and Mosaic Wholeness Center LLC (Rolling Meadows, IL). Each 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 Luis San Roman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Luis San Roman accept?
Health plans from Oscar Health list Luis San Roman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Luis San Roman was last updated on August 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Dr. Luis San Roman, LCPC · NPI 1124480595
Professional provider in Lake Bluff, Illinois. Individual provider, active in the CMS NPPES registry since March 24, 2016.
## Identity
- **NPI:** 1124480595 (Entity type: Individual)
- **Enumerated:** March 24, 2016
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 18012203 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 100 N WAUKEGAN RD STE 204, Lake Bluff, IL 60044-1660
- **Phone:** (847) 821-9346
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): White Stone Partners LLC (NPI 1801543616, Lake Bluff, IL); Mosaic Wholeness Center LLC (NPI 1245110782, Rolling Meadows, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** August 5, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1124480595) · Data from the CMS NPPES public registry.