Individual provider Active NPI

Jason F Heisler, PTA

  • Physical Therapy Assistant
  • Vero Beach, FL
National Provider Identifier
1366770141
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PT19747 Issued in FL
Practice address
2965 20TH St
Vero Beach, FL 32960-3097
Phone
(772) 567-8585
NPI assigned
Dec 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PT19747 FL Primary

Addresses

Primary practice location

2965 20TH St
Vero Beach, FL 32960-3097

Mailing address

5305 Stately Oaks St
Fort Pierce, FL 34981-3406
Phone (772) 215-2198

Other identifiers 1

IdentifierTypeStateIssuer
PT19747OtherFLPHYSICAL THERAPIST ASSISTANT

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
PT19747FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Motion Therapeutic Massage,Inc Past Accepting new patients
Advanced Motion Therapeutic Massage, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1366770141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 STATELY OAKS ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349813406",
            "telephone_number": "772-215-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 20TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603097",
            "telephone_number": "772-567-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISLER",
        "first_name": "JASON",
        "middle_name": "F",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PT19747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSISTANT",
            "identifier": "PT19747",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.