Matthew Lissak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

230099 Issued in NY

Practice address

105 E 63Rd St Apt 2B
New York, NY 10021-7328

Phone

(212) 838-0707

Fax

(212) 838-6781

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 1, 2013 through Jun 1, 2027

Specialty

Psychiatry

Education

JS Weill Medical College, Cornell University, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366570442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E 63RD ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217328",
            "telephone_number": "212-838-0707",
            "fax_number": "212-838-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 63RD ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217328",
            "telephone_number": "212-838-0707",
            "fax_number": "212-838-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSAK",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "230099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Menachem Liss, DO
• Meredith I Liss, MA, RD, CDN
• Polina Liss
• Stephanie Liss, PA-C
• Brian M Lissak, LCSW
• Boaz J Lissauer, MD
• Jessica Lisser
• Rebecca Lisson
• Philip Bernard Listengart, PSYCHOANALYST
• Amanda Lister, PHD

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• 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.