Individual provider Active NPI

Patrick J. Dungan, OTR, CHT

  • Occupational Therapist
  • Rockford, IL
National Provider Identifier
1871755983
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056011068 Issued in IL
Practice address
5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone
(815) 381-7431
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056011068 IL Primary

Addresses

Primary practice location

5875 E Riverside Blvd
Rockford, IL 61114-4937

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Other identifiers 1

IdentifierTypeStateIssuer
151100015OtherMOAREA 99

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160125002577 IL Practitioner - Occupational Therapist in Private Practice 9830245828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone (815) 398-9491

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100Reported as group
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056011068ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Occupational Therapist CurrentSince Feb 15, 2016 Accepting new patients
Orthomidwest, PLLC CurrentSince Feb 15, 2016 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1550 N Randall Rd
Elgin, IL 60123
Phone (815) 569-6355

1435 N Randall Rd
Ste 103
Elgin, IL 60123
Phone (847) 888-0750

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270

Interoperability endpoints

  • Direct secure messaging: patrick.dungan@ro.eclinicaldirectplus.com
  • Direct secure messaging: patrick.dungan.p2@direct.athleticoltd.nextgenshare.com

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1871755983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144937",
            "telephone_number": "815-381-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNGAN",
        "first_name": "PATRICK",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AREA 99",
            "identifier": "151100015",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.