Individual provider Active NPI

Lisa Sharon Bayliss, OTR/L

  • Rehabilitation Practitioner
  • Miller Place, NY
National Provider Identifier
1235180787
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
011323-1 Issued in NY
Practice address
269 Radio Ave
Miller Place, NY 11764-3528
Phone
(631) 205-5904
NPI assigned
May 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 011323-1 NY Primary

Addresses

Primary practice location

269 Radio Ave
Miller Place, NY 11764-3528

Mailing address

269 Radio Ave
Miller Place, NY 11764-3528
Phone (631) 205-5904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214000918 GA Practitioner - Occupational Therapist in Private Practice 9133131444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

1100 Reinhardt College Pkwy
Canton, GA 30114-2011
Phone (770) 721-2812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011323-1NYMDRehabilitation Practitioner
011323NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Behavioral Health, LLC Past Accepting new patients
Matthew Colucci P.T.,P.C. PastSince Mar 20, 2002 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235180787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643528",
            "telephone_number": "631-205-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643528",
            "telephone_number": "631-205-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLISS",
        "first_name": "LISA",
        "middle_name": "SHARON",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NY",
            "license": "011323-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.