Active NPI
Rebecca Lisa Utech
- Audiologist
- Buffalo, NY
National Provider Identifier
1790913788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 002259-1
- Practice address
- 2253 Main St
Buffalo, NY 14214-2349 - Phone
- (716) 834-7200
- Fax
- (716) 831-8678
- NPI assigned
- Jun 29, 2009
- Reactivated
- Jul 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 002259-1 | NY | Primary |
Addresses
Primary practice location
2253 Main St
Buffalo, NY 14214-2349
Mailing address
2253 Main Street
Buffalo, NY 14214
Phone (716) 834-7200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090812000709 | NY | Practitioner - Qualified Audiologist | 7012061989 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002259-1 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester Hearing and Speech Center | Past | Accepting new patients | |
| St. Mary's School for the Deaf | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Early Intervention Provider Agency
- Rochester, NY
- NPI 1932387131
-
- Local Education Agency (LEA)
- Buffalo, NY
- NPI 1093857575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1790913788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2253 MAIN STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14214",
"telephone_number": "716-834-7200",
"fax_number": "716-831-8678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2253 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142349",
"telephone_number": "716-834-7200",
"fax_number": "716-831-8678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTECH",
"first_name": "REBECCA",
"middle_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2014-07-23",
"deactivation_date": "2014-07-23",
"reactivation_date": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "002259-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 23, 2014; 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.