Individual provider Active NPI

Andy Qifeng Lin

  • Physical Therapy Clinic/Center
  • Plano, TX
National Provider Identifier
1134739865
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1331527 Issued in TX
Practice address
1300 N Central Expy
Plano, TX 75074-1009
Phone
(972) 578-2212
NPI assigned
Aug 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1331527 TX Primary

Addresses

Primary practice location

1300 N Central Expy
Plano, TX 75074-1009

Mailing address

4441 Caledonia Creek LN
Plano, TX 75024-7047
Phone (972) 834-9680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113000177 TX Practitioner - Physical Therapist in Private Practice 5496168403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctx3 PLLCGroup PAC ID 1355620055, 85 clinicians

Practice addresses (Care Compare)

3014 N O Connor Rd
200 Direct Orthopedic Care
Irving, TX 75062-4415
Phone (469) 648-2282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Doctx3 PLLC Physical Therapy CurrentSince Aug 2, 2021 Accepting new patients
Doctx3 PLLC CurrentSince Aug 2, 2021 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapy CurrentSince Dec 28, 2020 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Dec 28, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

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": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1134739865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 CALEDONIA CREEK LN",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247047",
            "telephone_number": "972-834-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N CENTRAL EXPY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750741009",
            "telephone_number": "972-578-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "ANDY",
        "middle_name": "QIFENG",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1331527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.