Individual provider Active NPI

Andrew S Lange, PT, DPT

  • Physical Therapist
  • Rockford, IL
National Provider Identifier
1245534619
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.017898 Issued in IL
Practice address
1215 N Alpine Rd
Rockford, IL 61107-2201
Phone
(815) 391-7800
NPI assigned
Dec 28, 2010
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 070.017898 IL Primary

Addresses

Primary practice location

1215 N Alpine Rd
Rockford, IL 61107-2201

Mailing address

520 Oak Knolls Ave
Rockford, IL 61107-4640

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000960 IL Practitioner - Physical Therapist in Private Practice 6103008339 Reassigns benefits to 1 organization

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
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.017898ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince May 26, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 26, 2020 Accepting new patients
Rebound Physical Therapy Center PC Physical Therapist Past Accepting new patients

Locations

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1245534619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 OAK KNOLLS AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N ALPINE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072201",
            "telephone_number": "815-391-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.017898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.