Lisa Michele Breton, PTA, LAC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

000064 Issued in CT

Practice address

35 Bunker Hill Rd
Watertown, CT 06795-3304

Phone

(860) 274-5429

NPI assigned

Sep 27, 2011

Last updated

Dec 7, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mending Roots Naturopathy LLC

  • Naturopath
  • Milford, CT
  • NPI 1669063368

  Acupuncturist

  NPD

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1013290915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 RIVER ST UNIT B",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603315",
            "telephone_number": "203-442-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BUNKER HILL RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067953304",
            "telephone_number": "860-274-5429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 River St Unit B",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064603315",
            "country_code": "US",
            "telephone_number": "203-442-6297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRETON",
        "first_name": "LISA",
        "middle_name": "MICHELE",
        "credential": "PTA, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CT",
            "license": "000860",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Michael Botros, R.PH, JD
• Robert Kingsbury Botta, M.D.
• Jenna Bouffard, LAT, ATC
• Jenna Ann Bourassa, LCSW
• Mary Jane Moran Brackett, MD
• Belinda Bridges, LCSW
• Samantha Brodeur
• Ashlyn Burbano
• Christina Calzadilla, BCBA-LBA
• Richard E Capozzi Jr., D.D.S.

• Physical Therapy Assistant in Watertown, CT
• Providers in Watertown, CT by specialty
• Physical Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.