Mr Mark Vincent Lange, MPT in Slc, UT - Medicare Physical Therapist Provider

Mr Mark Vincent Lange, MPT is a medicare enrolled "Physical Therapist" provider in Slc, Utah. His current practice location is Fairfax Rd At Virginia St, Slc, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 536-3616.

Mr Mark Vincent Lange is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558686428.

Contact Information

	Mr Mark Vincent Lange, MPT
	Fairfax Rd At Virginia St, Slc, UT 84103
	(801) 536-3616
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Mark Vincent Lange
Gender	Male
Speciality	Physical Therapist
Location	Fairfax Rd At Virginia St, Slc, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558686428
Provider Enumeration Date: 04/02/2010
Last Update Date: 07/20/2021

Medicare PECOS Information:

PECOS PAC ID: 9335546027
Enrollment ID: I20210922003342

Medical Identifiers

Medical identifiers for Mr Mark Vincent Lange such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558686428	NPI	-	NPPES
5611857-2401	Other	UT	UTAH STATE LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Mark Vincent Lange allows following entities to bill medicare on his behalf.

Provider Name	Shriners Hospitals For Children
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1396187282 PECOS PAC ID: 9133031933 Enrollment ID: O20140703000851

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Vincent Lange is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Mark Vincent Lange, MPT Fairfax Rd At Virginia St, Slc, UT 84103 Ph: (801) 536-3616	Mr Mark Vincent Lange, MPT Fairfax Rd At Virginia St, Slc, UT 84103 Ph: (801) 536-3616

Reviews and Comments

Physical Therapist in Slc, UT

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Bart Gillespie, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Foothill Blvd, Slc, UT 84148 Phone: 801-582-1565
Lisa Ena Barnes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Slc, UT 84113 Phone: 801-588-2000

Mr Mark Vincent Lange, MPT - Medicare Physical Therapist in Slc, UT