Samuel David Lustgarten, PHD
NPI 1477197929ActiveIndividual· Psychologist, Counseling· Madison, WI
Psychologist, Counseling (PHD) in Madison, Wisconsin, licensed in WI and OR, with an NPI issued in October 2019. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1477197929 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Oct 28, 2019 |
| Last updated in NPPES | Dec 29, 2022 |
| Certified by provider | Dec 29, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 3717-57 | WI |
| Psychologist, Counseling | 103TC1900X | 3178 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (WI) |
|---|
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