Individual provider Active NPI

Joan Stassel

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1487762415
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
813 Issued in AK
Practice address
2740 Lake Otis Pkwy
Anchorage, AK 99508-4141
Phone
(907) 743-3310
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 813 AK Primary

Addresses

Primary practice location

2740 Lake Otis Pkwy
Anchorage, AK 99508-4141

Mailing address

12101 Jerome St
Anchorage, AK 99516-2142

Other identifiers 1

IdentifierTypeStateIssuer
PT0813MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108000421 AK Practitioner - Physical Therapist in Private Practice 9234157272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chugach Physical Therapy Inc 10 clinicians

Practice addresses (Care Compare)

2740 Lake Otis Pkwy
Anchorage, AK 99508-4143
Phone (907) 743-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
813AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chugach Physical Therapy Inc Physical Therapist CurrentSince Jan 19, 2006 Accepting new patients
Medical Park Family Care, LLC Past Accepting new patients

Locations

2740 Lake Otis Pkwy
Anchorage, AK 99508
Phone (907) 743-3310

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487762415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 JEROME ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995162142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 LAKE OTIS PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084141",
            "telephone_number": "907-743-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASSEL",
        "first_name": "JOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0813",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.