Active NPI
Brian Fettner
- Physical Therapist
- Naples, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29997
- Practice address
- 1660 Medical Blvd Ste 200
Naples, FL 34110-1416 - Phone
- (239) 449-3072
- Fax
- (877) 334-1886
- NPI assigned
- Feb 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01595500 | NJ | |
| Physical Therapist | 225100000X | 29997 | FL | Primary |
Addresses
Primary practice location
1660 Medical Blvd Ste 200
Naples, FL 34110-1416
Mailing address
1660 Medical Blvd Ste 200
Naples, FL 34110-1416
Phone (239) 449-3072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9045 La Fontana Blvd
Suite 113
Boca Raton, FL 33434-5640
Phone (561) 482-8007
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29997 | FL | MD | Physical Therapist |
| 40QA01595500 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuroscience and Spine Associates PL | Multi-Specialty | Current | Accepting new patients |
| Tom Segal Physical Therapy, Inc. | Multi-Specialty | Current | Accepting new patients |
| Neuroscience and Spine Associates PL | Multi-Specialty | Current | Accepting new patients |
| Neuroscience and Spine Associates PL | Past | Accepting new patients |
Locations
9045 La Fontana Blvd
Ste 113
Boca Raton, FL 33434
Phone (561) 482-8007
6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000
1660 Medical Blvd
Ste 200
Naples, FL 34110
Phone (239) 566-3434
3451 Pine Ridge Rd
Ste 601
Naples, FL 34109
Organizations & group practices 4
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.
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- NPI 1669536645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546473600000",
"number": "1962893487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 MEDICAL BLVD STE 200",
"city": "NAPLES",
"state": "FL",
"postal_code": "341101416",
"telephone_number": "239-449-3072",
"fax_number": "877-334-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 MEDICAL BLVD STE 200",
"city": "NAPLES",
"state": "FL",
"postal_code": "341101416",
"telephone_number": "239-449-3072",
"fax_number": "877-334-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTNER",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-06",
"last_updated": "2019-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01595500",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "FL",
"license": "29997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.