Lisa Ann Smith, MSOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

015845 Issued in NY

Practice address

813 Fay Rd
Syracuse, NY 13219-3009

Phone

(315) 488-2951

NPI assigned

Sep 21, 2009

Last updated

Sep 21, 2009By 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 1

Addresses

Other names 1

• Lisa Ann Gouger Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Cerebral Palsy IncGroup PAC ID 5496734758, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Upstate Cerebral Palsy, Inc

  • Mental Health Counselor
  • Utica, NY
  • NPI 1780636506
  Medicare reassignment Care Compare group NPD
• Upstate Cerebral Palsy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Utica, NY
  • NPI 1215098207
  NPD
• Upstate Cerebral Palsy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Utica, NY
  • NPI 1578623617
  NPD

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1093049389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7745 ASHER DR",
            "city": "HOLLAND PATENT",
            "state": "NY",
            "postal_code": "133543601",
            "telephone_number": "315-335-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009",
            "telephone_number": "315-488-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "GOUGER",
            "middle_name": "ANN",
            "credential": "MSOTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelsey Kay Smith, CRPA
• Kevin James Smith
• Kyle Alan Smith
• Laurie G Smith, SLP
• Leigh C Smith, M.S. CCC-SLP
• Madalyn Frances Smith, LCSW
• Marcus Lacey Smith
• Marissa M Smith, MD
• Michelle Catherine Smith, LMSW-C
• Niosha Terea Smith, LPN

• Occupational Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.