Individual provider Active NPI

Dylan Lewis, PT

  • Physical Therapist
  • Hinsdale, IL
National Provider Identifier
1124330147
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-017834 Issued in IL
Practice address
100 W Chestnut St
Hinsdale, IL 60521-3387
Phone
(630) 481-7350
Fax
(630) 481-7352
NPI assigned
Jul 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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 070-017834 IL Primary

Addresses

Primary practice location

100 W Chestnut St
Hinsdale, IL 60521-3387

Mailing address

PO Box 416501
Boston, MA 02241-7594
Phone (914) 294-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121029000131 IL Practitioner - Physical Therapist in Private Practice 0941450993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5255 E Maryland St
Decatur, IL 62521-9705
Phone (217) 864-1264

Merit-based Incentive Payment System (MIPS)

Final score
85.68 of 100Reported as individual
Quality
94.64
Promoting interoperability
76
Improvement activities
40
Cost
77.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-017834ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Orthopedic Center, LLC CurrentSince Jan 2, 2017 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Feb 1, 2016 Accepting new patients
Midwest PCW PT, LLC Physical Therapist CurrentSince May 6, 2019 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Feb 1, 2016 Accepting new patients

Locations

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

5255 E Maryland St
Decatur, IL 62521
Phone (217) 864-1264

3785 N Water St
Decatur, IL 62526
Phone (217) 675-7111

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

100 W Chestnut St
Hinsdale, IL 60521
Phone (630) 481-7350

104 E Ashland Ave
Mt Zion, IL 62549
Phone (217) 864-2665

1045 N State Route 121
Mt Zion, IL 62549
Phone (217) 864-0820

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 4

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1124330147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417594",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CHESTNUT ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213387",
            "telephone_number": "630-481-7350",
            "fax_number": "630-481-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DYLAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-017834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.