Tara Elise Rezza, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

026318 Issued in NY

Practice address

1028 Main St FL 2
Buffalo, NY 14202-1102

Phone

(716) 859-5465

Fax

(716) 859-5585

NPI assigned

Sep 28, 2018

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

Other names 1

• Dr. Tara Benczkowski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaleida Health

  dba Buffalo General Hospital

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1639209596
  NPD

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1811472566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST FL 2",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021102",
            "telephone_number": "716-859-5465",
            "fax_number": "716-859-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 MAIN ST FL 2",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021102",
            "telephone_number": "716-859-5465",
            "fax_number": "716-859-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZZA",
        "first_name": "TARA",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "026318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BENCZKOWSKI",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Jo Reynolds, RN
• Martaysha Reynolds
• Renee M. Reynolds, M.D.
• William Alexander Reynolds, PSY.D.
• Yolonda Shirese Reynolds
• Kandis Rhines
• Tatiashia Rhines
• Kyungduk Rho, MD
• Lori Pasquale Rhoades, MS. CCC-SLP
• Shelly Marie Rhodes

• Psychologist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.