Nicole Ashley Balistreri, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6447-26 Issued in WI

Practice address

S11W29667 Summit Ave
Waukesha, WI 53188-9476

Phone

(262) 565-6124

NPI assigned

Jul 8, 2020

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Lifestriders, Inc.

  • Voluntary or Charitable Agency
  • Waukesha, WI
  • NPI 1831533470
  NPD (past)

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1700404597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 N ANDREA ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532242768",
            "telephone_number": "414-526-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S11W29667 SUMMIT AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531889476",
            "telephone_number": "262-565-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALISTRERI",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6447-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Anne Baker, PSYD, LPC
• Lisa A Baker
• Richard Norman Baker, CSW LPC
• Meaghan Elizabeth Bakkum, LCSW
• Dominique Balderas, LPC
• Linda Ball-Dicus
• Kathleen Ball, LCSW
• Meghan Ballard
• Isabella Jasmine Balma
• Merrie Charlotte Baltramonas, RD

• Occupational Therapist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.