Jeffrey Mark Lackner, PSY.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

012051 Issued in NY

Practice address

462 Grider St
Room G208
Buffalo, NY 14215-3021

Phone

(716) 898-5671

Fax

(716) 898-3040

NPI assigned

Jun 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Academic Medicine Services, Inc.

  dba UBMD Internal Medicine

  • Internal Medicine Physician
  • Williamsville, NY
  • NPI 1255394763
  Medicare reassignment Care Compare group NPD
• Academic Health Psychology Associates, P.C.

  • Cognitive & Behavioral Psychologist
  • Buffalo, NY
  • NPI 1013049279
  NPD (past) Authorized official
• University at Buffalo Surgeons Inc

  • Surgery Physician
  • Buffalo, NY
  • NPI 1508898305
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821293168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142260093",
            "telephone_number": "716-898-5671",
            "fax_number": "716-898-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "address_2": "ROOM G208",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-5671",
            "fax_number": "716-898-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "012051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00025302101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF1724",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000523299002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "6108856",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Paul Labonte
• Terrika Laboy, AGNP-BC
• Jeffrey John Lach, DO
• Jessica Marie Lachausse, M.S
• Cynthia Lackie, RPH
• Colleen Lacombe-Senecal, D.D.S.
• Melissa Lacount, B.A. / B.S.
• Christian Starr Ladd, LPN
• Elizabeth J Ladd
• Celine M Laduca, PNP

• Cognitive & Behavioral Psychologist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Cognitive & Behavioral Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.