Individual provider Active NPI

Richard Lichtenberg, M.S.

  • Diagnostic Radiology Physician
  • Harvey, IL
National Provider Identifier
1962465476
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036082391 Issued in IL
Practice address
1 Ingalls Dr
Harvey, IL 60426-3558
Phone
(708) 331-7800
Fax
(708) 339-0695
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036082391 IL Primary

Addresses

Primary practice location

1 Ingalls Dr
Harvey, IL 60426-3558

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7339

Other identifiers 1

IdentifierTypeStateIssuer
036082391MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050303000647 IL Practitioner - Diagnostic Radiology 6901859842
I20170821000197 MI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 6901859842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 363-7272

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (616) 363-7272

1618 Park Dr
Benton Harbor, MI 49022-2755
Phone (616) 363-7272

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035
  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
91.34
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients
Advanced Imaging Center LLC Past Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology PastSince Aug 17, 2015 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

844 Washington Ave
Holland, MI 49423
Phone (616) 355-3820

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: rlichtenberg1139231@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1962465476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 INGALLS DR",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263558",
            "telephone_number": "708-331-7800",
            "fax_number": "708-339-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENBERG",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036082391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082391",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.