Individual provider Active NPI

Dylan Andrew Lax, DPT

  • Physical Therapist
  • Fishers, IN
National Provider Identifier
1679074322
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05012807A Issued in IN
Practice address
14300 E 138TH Ste B
Fishers, IN 46037-0051
Phone
(800) 622-6575
NPI assigned
Feb 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05012807A IN Primary
Physical Therapist 225100000X 1303057 TX

Addresses

Primary practice location

14300 E 138TH Ste B
Fishers, IN 46037-0051

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407
Phone (800) 622-6575

Other practice location 1

3600 W Bethel Ave
Muncie, IN 47304-5407
Phone (800) 622-6575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201113002251 IN Practitioner - Physical Therapist in Private Practice 9638433691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Indiana Orthopedics LLCGroup PAC ID 5698667822, 148 clinicians

Practice addresses (Care Compare)

14300 E
138TH Suite B
Fishers, IN 46037-0051
Phone (317) 773-4301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Orthopedics, LLC CurrentSince Nov 16, 2020 Accepting new patients
Central Indiana Orthopedics LLC Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

14300 E 138th
Ste B
Fishers, IN 46037
Phone (317) 773-4301

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

Interoperability endpoints

  • Direct secure messaging: dylan.lax.p4@direct.beaconortho.nextgenshare.com

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1679074322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407",
            "telephone_number": "800-622-6575",
            "fax_number": "765-284-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 E 138TH STE B",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460370051",
            "telephone_number": "800-622-6575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 W Bethel Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473045407",
            "country_code": "US",
            "telephone_number": "800-622-6575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAX",
        "first_name": "DYLAN",
        "middle_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012807A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1303057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.