Individual provider Active NPI

Richard Duttweiler, PHYSICAL THERAPIST

  • Physical Therapist
  • Munster, IN
National Provider Identifier
1124068374
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05001602A Issued in IN
Practice address
759 45TH Ave
Ste. 202
Munster, IN 46321-2939
Phone
(219) 836-0193
Fax
(219) 836-2452
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05001602A IN Primary

Addresses

Primary practice location

759 45TH Ave
Ste. 202
Munster, IN 46321-2939

Mailing address

1040 Sierra Dr
Ste 400
Greenwood, IN 46143-7241
Phone (317) 865-8540

Other identifiers 1

IdentifierTypeStateIssuer
200530270MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041101000613 IN Practitioner - Physical Therapist in Private Practice 9436111515 Reassigns benefits to 2 organizations
I20210128000274 IL Practitioner - Physical Therapist in Private Practice 9436111515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Point Orthopedics LLC 17 clinicians

Practice addresses (Care Compare)

9445 Calumet Ave
Munster, IN 46321-2811
Phone (219) 836-1060

Merit-based Incentive Payment System (MIPS)

Final score
73.78 of 100Reported as group
Quality
53.01
Promoting interoperability
99
Improvement activities
40
Cost
60.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05001602AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
North Point Orthopedics LLC CurrentSince May 1, 2022 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Jul 5, 2021 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Jul 5, 2021 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
Illiana Surgery and Medical Center Physical Therapist Past Accepting new patients
Community Care Network Inc PastSince May 1, 2022 Accepting new patients
Diveris Orthopedics and Sports Medicine,PC Past Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

9445 Calumet Ave
Munster, IN 46321
Phone (219) 836-1060

2718 US Highway 52 W
Ste C
West Lafayette, IN 47906
Phone (765) 237-3508

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1124068374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "STE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-865-8540",
            "fax_number": "317-865-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 45TH AVE",
            "address_2": "STE. 202",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212939",
            "telephone_number": "219-836-0193",
            "fax_number": "219-836-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTWEILER",
        "first_name": "RICHARD",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001602A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.