Michael Andrew Dane, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006422 Issued in CT

Practice address

1579 Straits Tpke
Middlebury, CT 06762-1835

Phone

(203) 577-2002

Fax

(203) 577-2060

NPI assigned

Jul 7, 2005

Last updated

Nov 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Score, LLCGroup PAC ID 0749268175, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.77 of 100Reported as group

Quality

83.33

Improvement activities

40

Cost

91.44

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Score, LLC

  • Physical Therapist
  • Middlebury, CT
  • NPI 1891822607
  Medicare reassignment Care Compare group NPD Authorized official
• Active Orthopaedics PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Middlebury, CT
  • NPI 1083797401
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1699772475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-577-2002",
            "fax_number": "203-577-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-577-2002",
            "fax_number": "203-577-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANE",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS SHIELD",
            "identifier": "080006422CT07",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004207389",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650016540",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Marie Cosseboom, LCSW
• Lindsey Marie Cullmer, LMSW
• Joanne D'Angelo, D.M.D.
• D'Vine Medical Spa, LLC
• Loreen Richard Daigle, D.C.
• Joseph P Deluca, M.D.
• Alex Ralph Demac, M.D.
• Joseph Daniel Demayo, M.D.
• Krista Derosa
• Nadia Desimone, SLP

• Physical Therapist in Middlebury, CT
• Providers in Middlebury, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.