Lisa Marie Forestal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011316 Issued in NY

Practice address

100 High St
Buffalo, NY 14203-1126

Phone

(716) 859-1254

Fax

(716) 859-4586

NPI assigned

Feb 6, 2007

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 identifiers 1

Other names 1

• Lisa Marie Weller Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Excelsior Orthopaedics LLP

  • Orthopaedic Surgery Physician
  • Amherst, NY
  • NPI 1831196757
  Medicare reassignment NPD
• Excelsior Orthopaedics, LLP

  • Orthopaedic Surgery Physician
  • Amherst, NY
  • NPI 1003058462
  NPD
• University Orthopaedic Services Inc.

  • Orthopaedic Surgery Physician
  • Buffalo, NY
  • NPI 1396986501
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1205975232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST",
            "address_2": "HAYES A",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142143001",
            "telephone_number": "716-829-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-1254",
            "fax_number": "716-859-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORESTAL",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "011316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WELLER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Ford, MSED, CCC-SLP, TSSLD
• Kathleen C Ford
• Shana Ford
• Roger A Forden, M.D.
• Kenny C Foreman, LPN
• Stacey Forgensi, CRNA
• Alexis Forgit
• Aliya Diamond Forguson, RN BSN
• Ailsa Marina Forlenza
• Justine Forrest, MD

• Physician Assistant in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.