Jeffrey Lawrence Lisiecki, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

314856 Issued in NY

Practice address

737 Park Ave Apt 1C
New York, NY 10021-4264

Phone

(212) 680-4626

NPI assigned

Jun 8, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jlisiecki1792276@direct.texashealth.org
• Direct secure messaging: jlisiecki68012@northwell.direct-ci.com

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1447630199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 PARK AVE APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214264",
            "telephone_number": "212-680-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 PARK AVE APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214264",
            "telephone_number": "212-680-4626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9101 N Central Expy Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752315956",
            "country_code": "US",
            "telephone_number": "214-823-5023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E Medical Center Dr",
            "address_2": "2110 Tuabman Ctr, SPC 5346",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-998-6022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISIECKI",
        "first_name": "JEFFREY",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "S9341",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301107909",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "314856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matheus Lisboa Otero, MD
• Lindsay Ann Lisch, MA, CCC-SLP
• Victoria Rose Lisciandri
• Abram Lishansky
• Natalya Lishnevetsky, PA
• Arnold Lisio
• Rebecca Lisk, MD
• Lauri Ann Liskin, MD
• Martha Liskow
• Kelsey Lisle, M.S.ED.

• Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.