Individual provider Active NPI

Thomas Richard Lange, MPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1952731762
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18592 Issued in FL
Practice address
9570 SW 107TH Ave
Suite 201C
Miami, FL 33176-2788
Phone
(954) 980-8364
Fax
(786) 542-1142
NPI assigned
Nov 14, 2013
Last updated
Dec 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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 PT18592 FL Primary

Addresses

Primary practice location

9570 SW 107TH Ave
Suite 201C
Miami, FL 33176-2788

Mailing address

9570 SW 107TH Ave
Suite 201C
Miami, FL 33176-2788
Phone (954) 980-8364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170601000537 FL Practitioner - Physical Therapist in Private Practice 8426325127 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Waterway Med Group LLCGroup PAC ID 2163894064, 3 clinicians
Complete Medical of Florida IncGroup PAC ID 2365570686, 6 clinicians

Practice addresses (Care Compare)

7001 N Waterway Dr
Suite 107
Miami, FL 33155-2827
Phone (786) 542-9832

7811 Coral Way
Suite 132
Miami, FL 33155-6555
Phone (786) 294-0190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT18592FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Behavioral Center Inc CurrentSince Mar 2, 2023 Accepting new patients
Complete Medical of Florida Inc CurrentSince Oct 1, 2019 Accepting new patients
Miami Lakes Doctor's LLC CurrentSince Oct 1, 2020 Accepting new patients
Dolphin Rehab Center Inc CurrentSince Jun 25, 2025 Accepting new patients
Dolphin Rehab Center CurrentSince Jun 25, 2025 Accepting new patients
Waterway Med Group LLC CurrentSince Dec 31, 2022 Accepting new patients

Locations

7001 N Waterway Dr
Ste 107
Miami, FL 33155
Phone (786) 542-9832

7309 W Flagler St
Miami, FL 33144
Phone (786) 703-1390

7811 SW 24th St
Ste 132
Miami, FL 33155
Phone (786) 294-0190

5757 NW 151st St
Miami Lakes, FL 33014
Phone (786) 299-6333

1414 NW 107th Ave
Ste 102
Sweetwater, FL 33172
Phone (305) 779-4390

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1952731762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 SW 107TH AVE",
            "address_2": "SUITE 201C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762788",
            "telephone_number": "954-980-8364",
            "fax_number": "786-542-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 SW 107TH AVE",
            "address_2": "SUITE 201C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762788",
            "telephone_number": "954-980-8364",
            "fax_number": "786-542-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.