Stephan Maytawin Heddon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04891801 Issued in NY

Practice address

235 W 75TH St
New York, NY 10023-8220

Phone

(646) 518-5559

NPI assigned

Sep 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spear Physical and Occupational Therapy, LLC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1063454577

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Hand Physical Therapist
  • East Meadow, NY
  • NPI 1770540593
  Medicare reassignment NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1386366136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 5TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 75TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238220",
            "telephone_number": "646-518-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDDON",
        "first_name": "STEPHAN",
        "middle_name": "MAYTAWIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "04891801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Wesley Heckman, M.D.
• Hector H. Goa, MD, PC
• Alexandra Hector
• Amirali Hedayati
• Grace Dorothy Hedderman, MA, CRC
• Kareen Jodian Hedge
• Meghan Hedges, LCSW
• Cecil Hedigan, L.AC., M.S., L.M.T.
• Gideon Jacob Hedrych, MD
• Hedui Pharmacy Inc

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.