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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. AJENG JUWITA PUSPITASARI PHD
NPI 1346769759
Psychologist - Clinical in Milwaukee, WI

Active since September 18, 2017PECOS Enrolled
2153 N DR MARTIN LUTHER KING DR STE 2500, MILWAUKEE, WI 53212(414) 955-7276(414) 955-0146 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Aug 20, 2026, Nov 1, 2021, Aug 27, 2020 and 2 more (5 updates tracked since 2017).

About Dr. Ajeng Juwita Puspitasari Phd NPPES

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

DR. AJENG JUWITA PUSPITASARI PHD (NPI 1346769759) is an individual clinical provider in Milwaukee, Wisconsin, licensed in Wisconsin (5074-057) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1346769759
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. AJENG JUWITA PUSPITASARICredential: PHD
Location Address2153 N DR MARTIN LUTHER KING DR STE 2500Milwaukee, WI 53212-3101
Mailing Address2153 N Dr Martin Luther King Dr Ste 2500Milwaukee, WI 53212-3101 · (414) 955-7276 · Fax (414) 955-0146
Phone(414) 955-7276
Fax(414) 955-0146
Sole ProprietorNo
Enumeration DateSeptember 18, 2017
Last NPPES UpdateAugust 20, 20265 updates tracked since enumeration
NPPES CertifiedAugust 20, 2026
✔ NPI 1346769759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in WI · 5074-057✔ Licensed in MN · LP6254
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2153 N DR MARTIN LUTHER KING DR STE 2500, Milwaukee, WI 53212
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Secondary Practice Location 1

Location 1200 1st St SWRochester, MN 55905 · Phone (507) 284-2511

Other Identifiers 1

Medicaid1346769759WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Medica, Regence BlueCross BlueShield of Oregon and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ajeng Juwita Puspitasari Phd 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Ajeng Puspitasari's NPI number?

The NPI number for Ajeng Puspitasari is 1346769759. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Where is Ajeng Puspitasari located?

Ajeng Puspitasari practices at 2153 N Dr Martin Luther King Dr Ste 2500, Milwaukee, WI 53212. The listed phone number is (414) 955-7276.

What is Ajeng Puspitasari's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Ajeng Puspitasari enrolled in Medicare?

Yes. Ajeng Puspitasari is registered in the Medicare PECOS enrollment system.

What insurance does Ajeng Puspitasari accept?

Health plans from BridgeSpan Health Company, Medica, Regence BlueCross BlueShield of Oregon and UnitedHealthcare list Ajeng Puspitasari 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 Ajeng Puspitasari was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days 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.