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SAMUEL LUSTGARTEN PHD LLC
NPI 1427729227
Clinic/Center - Mental Health (Including Community Mental Health Center) in Madison, WI

Active since September 22, 2021
702 N BLACKHAWK AVE STE 205, MADISON, WI 53705(720) 260-4362(971) 999-0817 Get Directions Write a Review

NPPES record last updated: December 23, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 23, 2022, Sep 22, 2021 (2 updates tracked since 2021).

About Samuel Lustgarten Phd Llc NPPES

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

SAMUEL LUSTGARTEN PHD LLC (NPI 1427729227) is a healthcare organization registered as a mental health (including community mental health center) in Madison, Wisconsin and active in the NPI registry since September 2021. The organization lists Samuel David Lustgarten, Licensed Psychologist/owner, as its authorized official.

NPPES Registry Identity

NPI1427729227
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameSAMUEL LUSTGARTEN PHD LLC
Location Address702 N BLACKHAWK AVE STE 205Madison, WI 53705-3357
Mailing Address702 N Blackhawk Ave Ste 205Madison, WI 53705-3357 · (720) 260-4362 · Fax (971) 999-0817
Phone(720) 260-4362
Fax(971) 999-0817
Organization SubpartNo
Authorized OfficialSamuel David LustgartenLicensed Psychologist/owner · (720) 260-4362
Enumeration DateSeptember 22, 2021
Last NPPES UpdateDecember 23, 20222 updates tracked since enumeration
NPPES CertifiedDecember 23, 2022
✔ NPI 1427729227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
702 N BLACKHAWK AVE STE 205, Madison, WI 53705
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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)

Samuel Lustgarten Phd 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 Samuel Lustgarten Phd LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Samuel Lustgarten, PHD
Clinical Psychologist
NPI 1477197929
702 N BLACKHAWK AVE STE 205
Madison, WI 53705
(720) 260-4362
✔ PECOSSame address

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 Samuel Lustgarten Phd LLC's NPI number?

The NPI number for Samuel Lustgarten Phd LLC is 1427729227. It was assigned to this organization in the NPPES registry on September 22, 2021.

Where is Samuel Lustgarten Phd LLC located?

Samuel Lustgarten Phd LLC is located at 702 N Blackhawk Ave Ste 205, Madison, WI 53705. The listed phone number is (720) 260-4362.

What is Samuel Lustgarten Phd LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Samuel Lustgarten Phd LLC enrolled in Medicare?

Yes. Samuel Lustgarten Phd LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Samuel Lustgarten Phd LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Samuel Lustgarten Phd 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 Samuel Lustgarten Phd LLC accept?

Health plans from Dean Health Plan and Quartz list Samuel Lustgarten Phd 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 Samuel Lustgarten Phd LLC was last updated on December 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.