Jessica Laura Hettler, DPT, ATC, CERT MDT
Individual provider Active NPI Specialist · East Rockaway, NY
NPI 1225104656 · NPPES record last updated Apr 27, 2021
Key facts
- NPI
- 1225104656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 026463 (NY)
- Practice address
- 23 Rhame Ave
East Rockaway, NY 11518-1445 - Phone
- (516) 641-7364
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026463 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieve Physical Therapy and Wellness | Past |
Accepting new patients | |
| Southern Nassau Physical Therapy P C | Specialist | Past | Accepting new patients |
Interoperability endpoints
- jhettler8382@direct.hss.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 026463 | NY | Yes |
Addresses
Primary practice location
23 Rhame Ave
East Rockaway, NY 11518-1445
Mailing address
200 Atlantic Ave
Apt 401
Lynbrook, NY 11563-3511
Phone (516) 641-7364
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jhettler8382@direct.HSS.edu | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ | Direct | |
| FHIR URL | https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Direct |
Other providers in East Rockaway, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.