Individual provider Active NPI

Robert Blenner Hassett III, P.T.

  • Physical Therapist
  • Ukiah, CA
National Provider Identifier
1417937277
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 1381 Issued in CA
Practice address
3101 S State St
Suite a
Ukiah, CA 95482-6938
Phone
(707) 468-3844
Fax
(707) 468-5702
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 1381 CA Primary

Addresses

Primary practice location

3101 S State St
Suite a
Ukiah, CA 95482-6938

Mailing address

526 Baywood CT
Ukiah, CA 95482-6501
Phone (707) 468-5001

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 1381CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy at the Health Club Physical Therapist PastSince Jun 1, 1998 Accepting new patients

Organizations & group practices 1

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1417937277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 BAYWOOD CT",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826501",
            "telephone_number": "707-468-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 S STATE ST",
            "address_2": "SUITE A",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826938",
            "telephone_number": "707-468-3844",
            "fax_number": "707-468-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSETT",
        "first_name": "ROBERT",
        "middle_name": "BLENNER",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 1381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.