Individual provider Active NPI

Lisa M Briechle-Reese, OT

  • Occupational Therapist
  • Buffalo, NY
National Provider Identifier
1770547812
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2917 Main Street Unit 311
Buffalo, NY 14214
Phone
(716) 445-2369
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

2917 Main Street Unit 311
Buffalo, NY 14214

Mailing address

2917 Main Street Unit 311
Buffalo, NY 14214
Phone (716) 445-2369

Other identifiers 7

IdentifierTypeStateIssuer
02227461MedicaidNY
000670109001OtherNYBLUE CROSS BLUE SHIELD
040426003652OtherNYFIDELIS
9611520OtherNYIHA
838766OtherNYMANAGED PHYSICAL NETWORK
00011174501OtherNYUNIVERA
670002134OtherNYRR MEDICARE

Other names 1

  • Lisa M Briechle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000545 NY Practitioner - Occupational Therapist in Private Practice 7618934886 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010660NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Aug 27, 2024 Accepting new patients
Western New York PT Group PC Past Accepting new patients
Western New York Physical and Occupational Therapy Group PLLC Occupational Therapist PastSince Jan 1, 1999 Accepting new patients

Locations

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

Organizations & group practices 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1770547812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 MAIN STREET UNIT 311",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-445-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 MAIN STREET UNIT 311",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-445-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIECHLE-REESE",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02227461",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000670109001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426003652",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9611520",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED PHYSICAL NETWORK",
            "identifier": "838766",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00011174501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "670002134",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BRIECHLE",
            "middle_name": "M",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.