DR. SAMUEL DAVID LUSTGARTEN PHD
NPI 1477197929
Psychologist - Counseling in Madison, WI
NPI Status: Active since October 28, 2019
Contact Information
702 N BLACKHAWK AVE STE 205
MADISON, WI
ZIP 53705
Phone: (720) 260-4362
Fax: (971) 999-0817
- Individual
- Male
- Psychologist
- Counseling
- Accepts Insurance
- PECOS Enrolled
About SAMUEL LUSTGARTEN
This page provides the complete NPI Profile along with additional information for Samuel Lustgarten, a provider established in Madison, Wisconsin with a medical specialization in Psychologist, focusing in counseling . The healthcare provider is registered in the NPI registry with number 1477197929 assigned on October 2019. The practitioner's primary taxonomy code is 103TC1900X with license number 3717-57 (WI). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1477197929
- Provider Name
- DR. SAMUEL DAVID LUSTGARTEN PHD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 702 N BLACKHAWK AVE STE 205 MADISON, WI 53705
- Location Phone
- (720) 260-4362
- Location Fax
- (971) 999-0817
- Mailing Address
- 702 N BLACKHAWK AVE STE 205 MADISON, WI 53705
- Mailing Phone
- (720) 260-4362
- Mailing Fax
- (971) 999-0817
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-28-2019
- Last Update Date
- 12-29-2022
- Code Navigator
Location Map
Secondary Locations
- 7409 SW Capitol Hwy Ste 207
Portland, OR 97219
(720) 260-4362
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Counseling
- Taxonomy Code
- 103TC1900X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 3717-57
- License State
- WI
- Taxonomy Description
- A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | 3178 (OR) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE W/GUNDERSEN BRONZE $0 MEDICAL DED - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Samuel Lustgarten is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1477197929, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
MADISON, WI 53705
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477197929, enumerated as an "individual" on October 28, 2019.
The provider is located at 702 N BLACKHAWK AVE STE 205 MADISON, WI 53705 and the phone number is (720) 260-4362.
Psychologist with taxonomy code 103TC1900X and a focus in Counseling.
The provider might be accepting Accepts: Quartz. Please consult your insurance carrier or call the provider to verify.
