Individual provider Active NPI

Anthony Duvergel

  • Physical Therapist
  • Freeburg, IL
National Provider Identifier
1679352249
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2023038579 Issued in MO
Practice address
251 Marketplace Dr # 2
Freeburg, IL 62243-4082
Phone
(618) 539-5900
NPI assigned
Sep 25, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 2023038579 MO Primary

Addresses

Primary practice location

251 Marketplace Dr # 2
Freeburg, IL 62243-4082

Mailing address

7563 Clayton Rd Apt 302
Saint Louis, MO 63117-1442
Phone (314) 809-4033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231005001412 MO Practitioner - Physical Therapist in Private Practice 7618322082 Reassigns benefits to 1 organization
I20240101000079 IL Practitioner - Physical Therapist in Private Practice 7618322082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

13732 Olive Blvd
Chesterfield, MO 63017-2602
Phone (314) 786-5643

251 Marketplace Dr
Suite 2
Freeburg, IL 62243-4082
Phone (618) 539-5900

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
2023038579MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Nov 30, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients

Locations

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

144 Lincoln Place Ct
Ste 1
Belleville, IL 62221
Phone (618) 233-5163

251 Marketplace Dr
#2
Freeburg, IL 62243
Phone (618) 539-5900

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

884 Woods Mill Rd
Ste 200
Ballwin, MO 63011
Phone (636) 238-4910

13732 Olive Blvd
Chesterfield, MO 63017
Phone (314) 786-5643

4500 Telegraph Rd
Ste 204
Saint Louis, MO 63129
Phone (314) 487-1204

10435 Clayton Rd
Ste 10
Saint Louis, MO 63131
Phone (314) 442-6249

4590 S Lindbergh Blvd
Ste 102
Saint Louis, MO 63127
Phone (314) 200-4903

3322 S National Ave
Springfield, MO 65807
Phone (417) 881-9333

8567 Watson Rd
Ste C
Webster Groves, MO 63119
Phone (314) 732-1553

Organizations & group practices 8

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1679352249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7563 CLAYTON RD APT 302",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171442",
            "telephone_number": "314-809-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MARKETPLACE DR # 2",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622434082",
            "telephone_number": "618-539-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVERGEL",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2023038579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.