Individual provider Active NPI

Rebecca L Fisher, MS, OTR/L

  • Occupational Therapist
  • Ithaca, NY
National Provider Identifier
1912230301
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013428 Issued in NY
Practice address
15 Catherwood Rd
Ithaca, NY 14850-1071
Phone
(607) 227-4421
Fax
(607) 463-0602
NPI assigned
Sep 16, 2009
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013428 NY Primary

Addresses

Primary practice location

15 Catherwood Rd
Ithaca, NY 14850-1071

Mailing address

96 Gunderman Rd
Ithaca, NY 14850-8624
Phone (607) 227-4421

Other practice location 1

40 Curtis Rd
Ithaca, NY 14850-8659
Phone (607) 227-4421

Other practice location 2

840 Hanshaw Rd Ste 4
Ithaca, NY 14850-1589
Phone (607) 227-4421

Other identifiers 1

IdentifierTypeStateIssuer
04303086MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL emr Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130515000000 NY Practitioner - Occupational Therapist in Private Practice 6103063946 Reassigns benefits to 1 organization
Practice locations: Ithaca, NY

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Full Spectrum Occupational TherapyGroup PAC ID 4789074188, 4 clinicians

Practice addresses (Care Compare)

2415 N Triphammer Rd
Suite 11
Ithaca, NY 14850-1093
Phone (607) 227-4421

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013428NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Full Spectrum Occupational Therapy Occupational Therapist CurrentSince Dec 1, 2021 Accepting new patients

Locations

15 Catherwood Rd
Ithaca, NY 14850
Phone (607) 227-4421

2415 N Triphammer Rd
Ste 11
Ithaca, NY 14850
Phone (607) 227-4421

Interoperability endpoints

  • Direct secure messaging: full_spectrum_rehab@hiemail.healtheconnections.org

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, 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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1912230301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 GUNDERMAN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148508624",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CATHERWOOD RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501071",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148508659",
            "country_code": "US",
            "telephone_number": "607-227-4421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 Hanshaw Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501589",
            "country_code": "US",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2022-08-10",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04303086",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "emr",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 Catherwood Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.