Active NPI
Patrick J Lorge, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Madison, WI
National Provider Identifier
1568499101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 4597
- Practice address
- 5801 Research Park Blvd
Ste 110
Madison, WI 53719-6002 - Phone
- (608) 274-0770
- Fax
- (608) 274-9224
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 4597 | WI | Primary |
Addresses
Primary practice location
5801 Research Park Blvd
Ste 110
Madison, WI 53719-6002
Mailing address
7821 Summerfield Dr
Verona, WI 53593-8665
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10771 | Other | WI | DEAN HEALTH PLAN PROV# |
| 33720300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 13, 2015 through Apr 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4597 | WI | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madison Oral & Maxillofacial Surgeons SC | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Madison, WI
- NPI 1144261199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1568499101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7821 SUMMERFIELD DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535938665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 RESEARCH PARK BLVD",
"address_2": "STE 110",
"city": "MADISON",
"state": "WI",
"postal_code": "537196002",
"telephone_number": "608-274-0770",
"fax_number": "608-274-9224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORGE",
"first_name": "PATRICK",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "WI",
"license": "4597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN PROV#",
"identifier": "10771",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33720300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.