Individual provider Active NPI

Christie Lynn Cislo

  • Speech-Language Pathologist
  • Kenmore, NY
National Provider Identifier
1649792805
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2900 Delaware Ave
Kenmore, NY 14217-2309
Phone
(716) 871-9883
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary
Speech-Language Pathologist 235Z00000X 027624 NY

Addresses

Primary practice location

2900 Delaware Ave
Kenmore, NY 14217-2309

Mailing address

2900 Delaware Ave
Kenmore, NY 14217-2309

Other practice location 1

2255 Berg Rd
West Seneca, NY 14218-3781
Phone (716) 983-8723

Other identifiers 1

IdentifierTypeStateIssuer
BXF880873770OtherNYBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Practitioner Services of Wny PC Past Accepting new patients

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1649792805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309",
            "telephone_number": "716-871-9883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2255 Berg Rd",
            "address_purpose": "LOCATION",
            "city": "West Seneca",
            "state": "NY",
            "postal_code": "142183781",
            "country_code": "US",
            "telephone_number": "716-983-8723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISLO",
        "first_name": "CHRISTIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2025-09-12",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027624",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "BXF880873770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.