KELLY FASIG (DPT) – Physical Therapist, NPI 1497021133

KELLY FASIG (DPT) is a healthcare provider. based in Medina, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT 012418 (OH). The NPI Number for KELLY FASIG (DPT) is 1497021133

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
KELLY FASIG (DPT)
NPI
1497021133
Phone
(330) 754-7754
Address
3247 SEVEN BRIDGES RD
Enumeration Date
27 March 2012
Last Update Date
27 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4405582370
Graduation Year
2009 (17 years ago)
PAC ID
4789044678
Group Practice PAC ID
2163339722
Professional Enrollment ID
I20230725000291
Address ID
OH441331286CL9205XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

2,263 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for KELLY FASIG (DPT)

  • 3247 SEVEN BRIDGES RD

    MEDINA, OH 442566233

    Phone: (330) 754-7754

    Type: Mailing

  • 155 HERITAGE WOODS DR

    COPLEY, OH 443211398

    Phone: (330) 666-0980

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-25

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230725000291IPhysical Therapist In Private PracticeOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44256)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163339722View full group profile
NameSpecialtyState
-NY
Nurse PractitionerMI
Family PracticeTX
Physician AssistantNC
Internal Medicine, Pediatric MedicineNY
Family PracticeFL
Occupational Therapist In Private PracticeNC
Internal MedicineNC
Qualified Speech Language PathologistFL
Sleep MedicineNC

Reviews

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Frequently asked questions

How do payers reference KELLY FASIG (DPT)?
For KELLY FASIG (DPT), use NPI 1497021133 as the unique 10-digit identifier.
Active or inactive — what applies to KELLY FASIG (DPT)?
You should see KELLY FASIG (DPT) as active in CMS-hosted NPPES data.
What expertise is attributed to KELLY FASIG (DPT)?
KELLY FASIG (DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with KELLY FASIG (DPT)?
Directory geography for KELLY FASIG (DPT) centers on Medina, Ohio.
When was this NPI issued?
Enumeration for KELLY FASIG (DPT) is noted as March 27, 2012 where the registry provides it.

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