Individual provider Active NPI

Patricia M. Lukasiewicz, M.S., CCC-SLP

  • Speech-Language Pathologist
  • East Aurora, NY
National Provider Identifier
1861490328
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004094-1 Issued in NY
Practice address
97 Hamburg St
East Aurora, NY 14052-2139
Phone
(716) 652-6464
Fax
(716) 652-6499
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 004094-1 NY Primary

Addresses

Primary practice location

97 Hamburg St
East Aurora, NY 14052-2139

Mailing address

97 Hamburg St
East Aurora, NY 14052-2139
Phone (716) 652-6464

Other identifiers 3

IdentifierTypeStateIssuer
000640031002OtherNYBLUECROSS BLUESHIELD WNY
9211069OtherNYINDEPENDENT HEALTH
00025349301OtherNYUNIVERA HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
004094-1NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Audiology & Speech Associates, Inc. Speech-Language Pathologist PastSince Jan 1, 2000 Accepting new patients
Audigycare, LLC PastSince Jul 1, 2013 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.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1861490328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 HAMBURG ST",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522139",
            "telephone_number": "716-652-6464",
            "fax_number": "716-652-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 HAMBURG ST",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522139",
            "telephone_number": "716-652-6464",
            "fax_number": "716-652-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIEWICZ",
        "first_name": "PATRICIA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004094-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD WNY",
            "identifier": "000640031002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9211069",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA HEALTHCARE",
            "identifier": "00025349301",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.