Individual provider Active NPI

Kyle Edward Liszewski, PSY.D.

  • Clinical Psychologist
  • Amherst, NY
National Provider Identifier
1346964756
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
026037 Issued in NY
Practice address
85 Bryant Woods S
Amherst, NY 14228-3604
Phone
(716) 689-3333
NPI assigned
Sep 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 026037 NY Primary
Clinical Psychologist 103TC0700X 118136-01 NY

Addresses

Primary practice location

85 Bryant Woods S
Amherst, NY 14228-3604

Mailing address

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106003070 NY Practitioner - Clinical Psychologist 9739536293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Psychiatric Associates, LLPGroup PAC ID 6709774318, 35 clinicians

Practice addresses (Care Compare)

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118136-01NYMDClinical Psychologist
026037NYMDSpeech-Language Pathologist

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1346964756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BRYANT WOODS S",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283604",
            "telephone_number": "716-689-3333",
            "fax_number": "716-689-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BRYANT WOODS S",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283604",
            "telephone_number": "716-689-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISZEWSKI",
        "first_name": "KYLE",
        "middle_name": "EDWARD",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-29",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "026037",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "118136-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.