Individual provider Active NPI

Janet M Lisak, MOT,OTR,CHT

  • Occupational Therapist
  • Waterbury, CT
National Provider Identifier
1225272321
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003534 Issued in CT
Practice address
1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708
Phone
(203) 755-7115
Fax
(203) 755-7067
NPI assigned
Apr 21, 2009
Last updated
Sep 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 003534 CT Primary

Addresses

Primary practice location

1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708

Mailing address

1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708
Phone (203) 755-7115

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

State licenses

LicenseStateTypeSpecialty
003534CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1225272321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WEST MAIN STREET",
            "address_2": "BUILDING 2, THE HAND TO SHOULDER CENTER, LLC",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-7115",
            "fax_number": "203-755-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WEST MAIN STREET",
            "address_2": "BUILDING 2, THE HAND TO SHOULDER CENTER, LLC",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-7115",
            "fax_number": "203-755-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISAK",
        "first_name": "JANET",
        "middle_name": "M",
        "credential": "MOT,OTR,CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "003534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.