Brenda Lis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403392 Issued in NY

Practice address

69 Delaware Ave
Suite 1200
Buffalo, NY 14202

Phone

(716) 852-5900

NPI assigned

Aug 31, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanvir Shagar NP in Family Health PLLCGroup PAC ID 1658775606, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tanvir Shagar NP in Family Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
  • NPI 1871160515
  Medicare reassignment Care Compare group NPD
• Jotno Family Health Nurse Practitioner PLLC

  • Nurse Practitioner
  • Buffalo, NY
  • NPI 1013774363
  NPD
• Interim Health Care

  • Nursing Care Agency
  • Buffalo, NY
  • NPI 1801337993
  NPD (past)

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1467908244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4373 CLINTON STREET",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 DELAWARE AVE",
            "address_2": "SUITE 1200",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14202",
            "telephone_number": "716-852-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403392",
            "primary": true
        },
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "NY",
            "license": "412294-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Jonathan Lipman, LMSW
• Ellen C Lippa, DDS
• Linda Lipscomb, LPN
• Steven E Lipshultz, MD
• Danielle Marie Lipuma, PMHNP
• Dylan Lis
• Jessie Sherry Lis, RD,CDN
• Sara Kathleen Lis, LMHC-P
• Tracy Lynne Lis, N.P.
• Kathleen Lisborg

• Psychiatric/Mental Health Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.
• 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.