Individual provider Active NPI

Brigitte Ulisse, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1366288995
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
891 Delaware Ave
Buffalo, NY 14209-2007
Phone
(716) 626-6301
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

891 Delaware Ave
Buffalo, NY 14209-2007

Mailing address

891 Delaware Ave
Buffalo, NY 14209-2007

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251125004437 NJ Practitioner - Physician Assistant 3173015278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1175 Marlkress Rd
Unit 4353
Cherry Hill, NJ 08034-9995

25 Brighton Ave
Apt 1a
Belleville, NJ 07109-1274

46 Columbia Ave
Suite 48
Kearny, NJ 07032-2901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Rehab Medicine, P.C. CurrentSince Sep 5, 2025 Accepting new patients

Locations

1175 Marlkress Rd
Unit 4353
Cherry Hill, NJ 08034

119 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-3469

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": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1366288995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092007",
            "telephone_number": "716-626-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULISSE",
        "first_name": "BRIGITTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.