Heather E Fiske, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4682 Issued in CT

Practice address

85 Seymour St Ste 1003
Hartford, CT 06106-5529

Phone

(860) 696-2290

NPI assigned

Jan 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather E Tettelbach Former name

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BB Medical and Dermatology IncGroup PAC ID 8123396447, 5 clinicians

Farmington Valley Dermatology and Surgery LLCGroup PAC ID 8123240132, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.63 of 100Reported as group

Quality

75.35

Promoting interoperability

100

Improvement activities

40

Cost

71.44

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

83.36

Promoting interoperability

100

Improvement activities

40

Cost

75.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Farmington Valley Dermatology and Surgery, LLC

  • Dermatology Physician
  • Avon, CT
  • NPI 1164835153
  Medicare reassignment Care Compare group
• BB Medical and Dermatology Inc

  dba BB medical and dermatology

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1790210516
  Medicare reassignment Care Compare group
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216

  Surgical

  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  Medicare reassignment
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  NPD

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1649819731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "STE 1022",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065530",
            "telephone_number": "203-200-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST STE 1003",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065529",
            "telephone_number": "860-696-2290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hazard Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060825447",
            "country_code": "US",
            "telephone_number": "860-696-2380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-972-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISKE",
        "first_name": "HEATHER",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4682",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "TETTELBACH",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Byron R Fisher, LCSW
• Christine A. Fisher, MS, NCC
• Daniel G. Fisher, MD
• Stephen Fishman, MD
• Theodore David Fishman, M.D.
• Marissa J Fistola, PA
• Hailey Fitzgerald, PA-C
• Kristina Marie Fitzgerald, APRN
• Meghan Fitzgerald, LCSW
• Kylie Marie Fitzpatrick, PA-C

• Surgical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.