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TROY LEE APSW
NPI 1376320432
Social Worker - Clinical in Fitchburg, WI

Active since September 12, 2023PECOS EnrolledAccepts Medicare Assignment
3051 CAHILL MAIN, FITCHBURG, WI 53711(608) 251-4156 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Troy Lee Apsw NPPES

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

TROY LEE APSW (NPI 1376320432) is an individual clinical provider in Fitchburg, Wisconsin, licensed in Wisconsin (12453-123) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1376320432
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTROY LEECredential: APSW
Location Address3051 CAHILL MAINFitchburg, WI 53711-7109
Mailing Address1265 John Q Hammons DrMadison, WI 53717-1921 · (608) 251-4156
Phone(608) 251-4156
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 12, 2023
Last NPPES UpdateNovember 18, 2025
NPPES CertifiedNovember 18, 2025
✔ NPI 1376320432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WI · 12453-123
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3051 CAHILL MAIN, Fitchburg, WI 53711
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, Group Health Cooperative-SCW, MercyCare and more.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

Troy Lee Apsw 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.

PECOS PAC ID8729564901
PECOS Enrollment IDI20260107003016
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 Troy Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Group Health Cooperative Of South Central Wisconsin
6.2 mi
Health Maintenance Organization
1265 JOHN Q HAMMONS DR
Madison, WI 53717
  • Reassigned Medicare billing, Wisconsin enrollment
  • 422 clinicians in this Medicare group
NPI 1245260165 (608) 251-4156

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53711 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
$0.00 typical visit price
range $53.90 – $163.24
Typical copayment $0.00 (range $13.47 – $40.81)
Most-billed visit code NA
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LYNNE LOUISE SVETNICKA APNP
Nurse Practitioner
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 257-9700
MARK P. HUTH MD
Family Medicine
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7200
KATELYN D BEEMON APNP
Nurse Practitioner
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7200
LARK LAUREN REASONER MD
Psychiatry & Neurology (Psychiatry)
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7200
ANN PATKOWSKI OD
Optometrist
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7200
MR. ROBERT CHARLES MULLER R.PH.
Pharmacist
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7220
CLAUDIA MARTE
Counselor (Mental Health)
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 622-7870
ELIZABETH DURIS MS, LCGC
Genetic Counselor, MS
3051 CAHILL MAIN
FITCHBURG, WI 53711
Dane County (608) 661-7293

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 Troy Lee's NPI number?

The NPI number for Troy Lee is 1376320432. It was assigned to this individual provider in the NPPES registry on September 12, 2023.

Where is Troy Lee located?

Troy Lee practices at 3051 Cahill Main, Fitchburg, WI 53711. The listed phone number is (608) 251-4156.

What is Troy Lee's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Troy Lee enrolled in Medicare?

Yes. Troy Lee 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 organization bills Medicare for Troy Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Troy Lee reassigns Medicare benefits to Group Health Cooperative Of South Central Wisconsin (Madison, WI). 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 Troy Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Troy Lee accept?

Health plans from Aspirus Health Plan, Group Health Cooperative-SCW, MercyCare, MercyCare Health Plans and Quartz list Troy Lee 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 Troy Lee was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.