NPIMap

Individual provider Active NPI

Thomas H Lange, MD

  • Surgery Physician
  • Willmar, MN
National Provider Identifier
1215903000
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
43700 Issued in MN
Practice address
101 Willmar Ave SW
Willmar, MN 56201
Phone
(320) 231-5000
Fax
(320) 231-5067
NPI assigned
Feb 23, 2006
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 43700 MN Primary

Addresses

Primary practice location

101 Willmar Ave SW
Willmar, MN 56201

Mailing address

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5000

Other identifiers 1

IdentifierTypeStateIssuer
161670600MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlange29772@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000823 MN Practitioner - General Surgery 0446391593 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43700MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health - Benson LLC CurrentSince Jan 17, 2023 Accepting new patients
Swift County Benson Hospital CurrentSince Nov 27, 2017 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients
Swift County-Benson Hospital CurrentSince Nov 27, 2017 Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Centracare Health - Benson LLC Current Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 30, 2019 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 30, 2019 Accepting new patients
Redwood Area Hospital Current Accepting new patients
Centracare Health - Benson LLC CurrentSince Jan 17, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

101 Caring Way
Redwood Falls, MN 56283
Phone (507) 637-2911

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: tlange29772@direct.centracare.com

Organizations & group practices 12

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1215903000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "THOMAS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "43700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161670600",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlange29772@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tlange29772@direct.centracare.com",
            "address_1": "101 Willmar Ave SW",
            "city": "Willmar",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.