Individual provider Active NPI

Lisa Ann Roussi, SLP

  • Speech-Language Pathologist
  • Orchard Park, NY
National Provider Identifier
1235315060
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005904-1 Issued in NY
Practice address
6167 W Quaker St
Orchard Park, NY 14127-2640
Phone
(716) 662-4800
Fax
(716) 662-5700
NPI assigned
Jan 10, 2008
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 005904-1 NY Primary

Addresses

Primary practice location

6167 W Quaker St
Orchard Park, NY 14127-2640

Mailing address

64 Highland Dr
Williamsville, NY 14221-6802
Phone (716) 633-8163

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005904-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Link for Children, PLLC Past Accepting new patients
Therapeutic Link for Children Past Accepting new patients

Organizations & group practices 2

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1235315060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 HIGHLAND DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216802",
            "telephone_number": "716-633-8163",
            "fax_number": "716-662-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6167 W QUAKER ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272640",
            "telephone_number": "716-662-4800",
            "fax_number": "716-662-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSI",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005904-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.