Dr Samuel David Lustgarten, PHD in Madison, WI - Medicare Psychologist Provider

Dr Samuel David Lustgarten, PHD is a medicare enrolled "Psychologist - Counseling" provider in Madison, Wisconsin. His current practice location is 702 N Blackhawk Ave Ste 205, Madison, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (720) 260-4362.

Dr Samuel David Lustgarten is licensed to practice in Wisconsin (license number 3717-57) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1477197929.

Contact Information

	Dr Samuel David Lustgarten, PHD
	702 N Blackhawk Ave Ste 205, Madison, WI 53705-3357
	(720) 260-4362
	(971) 999-0817

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Samuel David Lustgarten
Gender	Male
Speciality	Psychologist - Counseling
Location	702 N Blackhawk Ave Ste 205, Madison, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477197929
Provider Enumeration Date: 10/28/2019
Last Update Date: 12/29/2022

Medicare PECOS Information:

PECOS PAC ID: 9830564418
Enrollment ID: I20230413000140

Medical Identifiers

Medical identifiers for Dr Samuel David Lustgarten such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477197929	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC1900X	Psychologist - Counseling	3178 (Oregon)	Secondary
103TC1900X	Psychologist - Counseling	3717-57 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Samuel David Lustgarten allows following entities to bill medicare on his behalf.

Entity Name	Samuel Lustgarten Phd Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427729227 PECOS PAC ID: 8921473505 Enrollment ID: O20230413000113

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Samuel David Lustgarten is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Samuel David Lustgarten, PHD 702 N Blackhawk Ave Ste 205, Madison, WI 53705-3357 Ph: (720) 260-4362	Dr Samuel David Lustgarten, PHD 702 N Blackhawk Ave Ste 205, Madison, WI 53705-3357 Ph: (720) 260-4362

Reviews and Comments

Psychologist in Madison, WI

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Dr Samuel David Lustgarten, PHD - Medicare Psychologist in Madison, WI