Individual provider Active NPI

Leslie Dirisio, RPA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1184640419
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006737 Issued in NY
Practice address
1561 Long Pond Rd
Suite 408
Rochester, NY 14626-4117
Phone
(585) 442-4141
Fax
(585) 442-6259
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 006737 NY Primary

Addresses

Primary practice location

1561 Long Pond Rd
Suite 408
Rochester, NY 14626-4117

Mailing address

1561 Long Pond Rd
Suite 408
Rochester, NY 14626-4117
Phone (585) 442-4141

Other identifiers 1

IdentifierTypeStateIssuer
02507835MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Jul 25, 2013 Accepting new patients

Locations

1561 Long Pond Rd
Ste 408
Rochester, NY 14626
Phone (585) 442-4141

1555 Long Pond Rd
Ste 408
Rochester, NY 14626

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1184640419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 408",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-442-4141",
            "fax_number": "585-442-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 408",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-442-4141",
            "fax_number": "585-442-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRISIO",
        "first_name": "LESLIE",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02507835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.