Individual provider Active NPI

Michael Lockenvitz, DPT

  • Physical Therapist
  • Granite City, IL
National Provider Identifier
1407566011
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.027116 Issued in IL
Practice address
1503 Lindell Blvd
Granite City, IL 62040-3837
Phone
(618) 709-4125
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 070.027116 IL Primary

Addresses

Primary practice location

1503 Lindell Blvd
Granite City, IL 62040-3837

Mailing address

1503 Lindell Blvd
Granite City, IL 62040-3837
Phone (618) 709-4125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229001116 IL Practitioner - Physical Therapist in Private Practice 4284004680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

1503 Lindell Blvd
Granite City, IL 62040-3837
Phone (618) 709-4125

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.027116ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Nov 17, 2022 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Nov 17, 2022 Accepting new patients

Locations

1350 Grand Ave
Beardstown, IL 62618
Phone (217) 350-0361

1095 Belt Line Rd
Ste 400
Collinsville, IL 62234
Phone (618) 477-8550

1503 Lindell Blvd
Granite City, IL 62040
Phone (618) 709-4125

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

427 Edwardsville Rd
Ste 2
Troy, IL 62294
Phone (618) 505-1398

Organizations & group practices 2

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1407566011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 LINDELL BLVD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403837",
            "telephone_number": "618-709-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 LINDELL BLVD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403837",
            "telephone_number": "618-709-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKENVITZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.