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JAMES THOMAS LIPUSCH LCSW
NPI 1548376726
Social Worker - Clinical in Sheboygan, WI

Active since August 21, 2006PECOS EnrolledAccepts Medicare Assignment
3425 SUPERIOR ST, SHEBOYGAN, WI 53081(920) 458-5557(920) 458-2692 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About James Thomas Lipusch Lcsw NPPES

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

JAMES THOMAS LIPUSCH LCSW (NPI 1548376726) is an individual clinical provider in Sheboygan, Wisconsin, licensed in Wisconsin (2080123) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mequon, and is a graduate of University Of Wisconsin School Of Medicine (1977).

NPPES Registry Identity

NPI1548376726
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJAMES THOMAS LIPUSCHCredential: LCSW
Location Address3425 SUPERIOR STSheboygan, WI 53081
Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630 · (262) 912-1922
Phone(920) 458-5557
Fax(920) 458-2692
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1977
Enumeration DateAugust 21, 2006
Last NPPES UpdateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
✔ NPI 1548376726 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 · 2080123
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.
3425 SUPERIOR ST, Sheboygan, WI 53081
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Secondary Practice Location 1

Location 111649 N Port Washington Rd Ste 201&221Mequon, WI 53092-3460 · Phone (262) 999-3495

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan 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

James Thomas Lipusch Lcsw 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 ID5991808933
PECOS Enrollment IDI20070313000446
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 Reassignments

2

Medicare enrollment records show James Lipusch reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Columbia St. Mary's Hospital Milwaukee, Inc
36 mi
Multi-Specialty
13111 N PORT WASHINGTON RD
Mequon, WI 53097
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Columbia St Marys Hospital Milwaukee Inc
  • 856 clinicians in this Medicare group
NPI 1710928221 (414) 270-4932
Cornerstone Counseling Services, Inc
53 mi
Mental Health
16535 W BLUEMOUND RD, SUITE 200
Brookfield, WI 53005
  • Reassigned Medicare billing, Wisconsin enrollment
  • 556 clinicians in this Medicare group
NPI 1033127246 (262) 789-1191

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
170 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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.

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 James Lipusch's NPI number?

The NPI number for James Lipusch is 1548376726. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is James Lipusch located?

James Lipusch practices at 3425 Superior St, Sheboygan, WI 53081. The listed phone number is (920) 458-5557.

What is James Lipusch's specialty?

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

Is James Lipusch enrolled in Medicare?

Yes. James Lipusch 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 organizations bill Medicare for James Lipusch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Lipusch reassigns Medicare benefits to 2 organizations: Columbia St. Mary's Hospital Milwaukee, Inc (Mequon, WI) and Cornerstone Counseling Services, Inc (Brookfield, WI). Each 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 James Lipusch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Lipusch accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan, HealthPartners and Medica and 3 other insurers list James Lipusch 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 James Lipusch was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.