Individual provider Active NPI

Amanda C Breese, PHD

  • School Psychologist
  • Amherst, NY
National Provider Identifier
1114702602
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
4476 Main St Ste 204
Amherst, NY 14226-4465
Phone
(585) 770-7190
NPI assigned
Aug 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 68-P131891-01 NY
School Psychologist 103TS0200X Primary

Addresses

Primary practice location

4476 Main St Ste 204
Amherst, NY 14226-4465

Mailing address

344 Cayuga Rd
Buffalo, NY 14225-1940
Phone (607) 793-3962

Other practice location 1

4 South St
Geneseo, NY 14454-1310
Phone (585) 770-7190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006003728 NY Practitioner - Psychologist Billing Independently 6305343534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 White Spruce Blvd
Suite 220
Rochester, NY 14623-1605

4647 W Cedar Lake Rd
Greenbush, MI 48738-9716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
68-P131891-01NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Psychology, PLLC CurrentSince Sep 25, 2025 Accepting new patients
Vascular Surgery of the University PastSince Sep 25, 2025 Accepting new patients
Harry M. Barsuk, LMHC, LLC PastSince Sep 17, 2023 Accepting new patients
Meridian Psychology Practice, PLLC Clinical PastSince Dec 18, 2022 Accepting new patients

Locations

200 White Spruce Blvd
Ste 220
Rochester, NY 14623
Phone (585) 270-1679

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.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1114702602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 CAYUGA RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142251940",
            "telephone_number": "607-793-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 MAIN ST STE 204",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264465",
            "telephone_number": "585-770-7190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 South St",
            "address_purpose": "LOCATION",
            "city": "Geneseo",
            "state": "NY",
            "postal_code": "144541310",
            "country_code": "US",
            "telephone_number": "585-770-7190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREESE",
        "first_name": "AMANDA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68-P131891-01",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.