Individual provider Active NPI

Michael J Fassler

  • Student in an Organized Health Care Education/Training Program
  • Sterling, IL
National Provider Identifier
1619524717
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
18174 Freeport Rd
Sterling, IL 61081-9737
Phone
(815) 213-0143
NPI assigned
Aug 22, 2019
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

18174 Freeport Rd
Sterling, IL 61081-9737

Mailing address

18174 Freeport Rd
Sterling, IL 61081-9737
Phone (815) 213-0143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103000585 FL Order and Referring Only - General SurgeryPractitioner - General Surgery 2062822059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mfassler459921@direct.shands.ufl.edu

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1619524717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18174 FREEPORT RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610819737",
            "telephone_number": "815-213-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18174 FREEPORT RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610819737",
            "telephone_number": "815-213-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSLER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.