Individual provider Active NPI

Michaela Hess, PTA, ATC

  • Physical Therapy Assistant
  • Monroe, NY
National Provider Identifier
1174052963
Registry record updated Jun 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
007487-1 Issued in NY
Practice address
411 State Route 17M
Monroe, NY 10950-4123
Phone
(845) 507-0477
Fax
(845) 507-0490
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 001935-1 NY
Physical Therapy Assistant 225200000X 007487-1 NY Primary

Addresses

Primary practice location

411 State Route 17M
Monroe, NY 10950-4123

Mailing address

143 Valley View Ave
Monroe, NY 10950-1156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007487-1NYMDPhysical Therapy Assistant
001935-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1174052963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 VALLEY VIEW AVE",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504123",
            "telephone_number": "845-507-0477",
            "fax_number": "845-507-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESS",
        "first_name": "MICHAELA",
        "credential": "PTA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001935-1",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "007487-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.