Individual provider Active NPI

Heather Lynne Fassell, MS,PT, DPT

  • Physical Therapist
  • Poughkeepsie, NY
National Provider Identifier
1649202912
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0243131 Issued in NY
Practice address
1910 South Rd
Poughkeepsie, NY 12601-6027
Phone
(845) 454-0120
Fax
(845) 454-6080
NPI assigned
Jul 7, 2006
Last updated
Mar 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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 0243131 NY Primary

Addresses

Primary practice location

1910 South Rd
Poughkeepsie, NY 12601-6027

Mailing address

1910 South Rd
Poughkeepsie, NY 12601-6027
Phone (845) 454-0120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040331000633 NY Practitioner - Physical Therapist in Private Practice 6002808094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0243131NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gotham City Sports Medicine, PLLC CurrentSince Jun 1, 2018 Accepting new patients
Physical Therapy Associates of Schenectady Physical Therapist Past Accepting new patients
Physical Therapy Associates of Schenectady, P.C. Physical Therapist Past Accepting new patients
Physical Therapy Associates of Schenectady, PC Physical Therapist Past Accepting new patients
Physical Therapy Associates of Schenectady, P.C. Physical Therapist Past Accepting new patients
Sovereign Medical Group LLC Past Accepting new patients

Locations

50 Mount Prospect Ave
Ste 104
Clifton, NJ 07013
Phone (973) 928-1325

20 E 46th St
New York, NY 10017
Phone (212) 353-0030

20 E 46th St
Rm 600
New York, NY 10017
Phone (973) 928-1325

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1649202912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SOUTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126016027",
            "telephone_number": "845-454-0120",
            "fax_number": "845-454-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SOUTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126016027",
            "telephone_number": "845-454-0120",
            "fax_number": "845-454-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSELL",
        "first_name": "HEATHER",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MS,PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0243131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.