Individual provider Active NPI

Joshua C Lavigne, PH.D.

  • Clinical Neuropsychologist
  • McHenry, IL
National Provider Identifier
1174896633
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071008295 Issued in IL
Practice address
659 Ridgeview Dr
McHenry, IL 60050-7012
Phone
(815) 344-1999
Fax
(815) 516-5171
NPI assigned
Feb 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071008295 IL
Clinical Neuropsychologist 103G00000X 071008295 IL Primary

Addresses

Primary practice location

659 Ridgeview Dr
McHenry, IL 60050-7012

Mailing address

659 Ridgeview Dr
McHenry, IL 60050-7012
Phone (815) 344-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120518000126 IL Practitioner - Clinical Psychologist 5496918013 Reassigns benefits to 2 organizations
Practice locations: Woodstock, IL; Wauconda, IL; McHenry, IL; Crystal Lake, IL; Fox Lake, IL; Cary, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Un of British Columbia, Faculty of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuroclinic and Assessments LLCGroup PAC ID 1658524475, 5 clinicians

Practice addresses (Care Compare)

659 Ridgeview Dr
McHenry, IL 60050-7012
Phone (815) 344-1999

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071008295ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2023 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

360 Station Dr
Ste 300A
Crystal Lake, IL 60014
Phone (815) 788-7500

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 3

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": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1174896633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 RIDGEVIEW DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507012",
            "telephone_number": "815-344-1999",
            "fax_number": "815-516-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 RIDGEVIEW DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507012",
            "telephone_number": "815-344-1999",
            "fax_number": "815-516-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIGNE",
        "first_name": "JOSHUA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008295",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071008295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.