Organization Active NPI

Psychological Addiction Services LLC

  • Methadone Clinic
  • Madison, WI
National Provider Identifier
1881131761
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PSYCHOLOGICAL ADDICTION SERVICES LLC
Practice address
3113 E Washington Ave
Madison, WI 53704-4330
Phone
(608) 416-5777
Fax
(608) 416-5776
NPI assigned
Jan 30, 2017
Last updated
Oct 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donald A Zukowski
Title
President
Phone
(608) 225-8954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

3113 E Washington Ave
Madison, WI 53704-4330

Mailing address

3113 E Washington Ave
Madison, WI 53704-4330
Phone (608) 416-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments
Opioid treatment program
Medicare-enrolled since Jun 15, 2022

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181026000046 WI Part B Supplier - Clinic/Group Practice 6800149592 Receives reassigned benefits from 5 practitioners
Practice locations: Madison, WI
O20200423002921 WI Part B Supplier - Opioid Treatment Program (Otp) 6800149592 Practice locations: Madison, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2128477Psychological Addiction Services, LLC3113 E Washington Ave, Madison, WI 53704Certificate of waiverAug 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1881131761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044330",
            "telephone_number": "608-416-5777",
            "fax_number": "608-416-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044330",
            "telephone_number": "608-416-5777",
            "fax_number": "608-416-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ADDICTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "ZUKOWSKI",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-225-8954"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.