Active NPI
Shane Sasser, PT
- Physical Therapist
- Albuquerque, NM
National Provider Identifier
1821486226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1968
- Practice address
- 10101 Lagrima de Oro Rd NE
Albuquerque, NM 87111-6022 - Phone
- (505) 298-1231
- NPI assigned
- Jan 7, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1968 | NM | Primary |
Addresses
Primary practice location
10101 Lagrima de Oro Rd NE
Albuquerque, NM 87111-6022
Mailing address
PO Box 90893
Albuquerque, NM 87199-0893
Phone (505) 620-5766
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1968 | NM | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420588800000",
"number": "1821486226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 90893",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871990893",
"telephone_number": "505-620-5766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10101 LAGRIMA DE ORO RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871116022",
"telephone_number": "505-298-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASSER",
"first_name": "SHANE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-07",
"last_updated": "2015-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "1968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.