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OPEN SPACE LLC
NPI 1194553404
Counselor - Professional in Madison, WI

Active since July 26, 2024
402 GAMMON PL STE 290, MADISON, WI 53719(608) 370-9063 Get Directions Write a Review

NPPES record last updated: July 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Open Space Llc NPPES

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

OPEN SPACE LLC (NPI 1194553404) is a healthcare organization registered as a professional in Madison, Wisconsin and active in the NPI registry since July 2024. The organization lists Sara Jordan, Owner/director, as its authorized official.

NPPES Registry Identity

NPI1194553404
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameOPEN SPACE LLC
Location Address402 GAMMON PL STE 290Madison, WI 53719-1075
Mailing Address4801 Tocora LnMadison, WI 53711-1222 · (608) 370-9063
Phone(608) 370-9063
Organization SubpartNo
Authorized OfficialSara JordanOwner/director · (608) 370-9063
Enumeration DateJuly 26, 2024
NPPES CertifiedJuly 26, 2024
✔ NPI 1194553404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
402 GAMMON PL STE 290, Madison, WI 53719
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Other Names 1

Doing Business AsOpen Space Llc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, Quartz.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Open Space Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Open Space LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sara Jordan, LPC
Mental Health Counselor
NPI 1649493917
414 DONOFRIO DR STE 330
Madison, WI 53719
(608) 284-8222
✔ PECOS0.6 mi

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

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 Open Space LLC's NPI number?

The NPI number for Open Space LLC is 1194553404. It was assigned to this organization in the NPPES registry on July 26, 2024.

Where is Open Space LLC located?

Open Space LLC is located at 402 Gammon Pl Ste 290, Madison, WI 53719. The listed phone number is (608) 370-9063.

What is Open Space LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Open Space LLC enrolled in Medicare?

Yes. Open Space LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Open Space LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Open Space LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Open Space LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan and Quartz list Open Space LLC 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 Open Space LLC was last updated on July 26, 2024. 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.