Individual provider Active NPI

Rebecca Lissitschenko, N.P.

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1902956972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F330651 Issued in NY
Practice address
425 Michigan Ave
Buffalo, NY 14203-2209
Phone
(716) 848-2123
Fax
(716) 848-2125
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F330651 NY Primary

Addresses

Primary practice location

425 Michigan Ave
Buffalo, NY 14203-2209

Mailing address

3341 Creekview Dr
Hamburg, NY 14075-3640
Phone (716) 648-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000269 NY Practitioner - Nurse Practitioner 7315908514 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Buffalo School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F330651NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Kenmore Mercy Hospital Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Kenmore Mercy Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

565 Abbott Rd
#2
Buffalo, NY 14220

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902956972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 CREEKVIEW DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753640",
            "telephone_number": "716-648-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MICHIGAN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032209",
            "telephone_number": "716-848-2123",
            "fax_number": "716-848-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSITSCHENKO",
        "first_name": "REBECCA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.