Individual provider Active NPI

Lisa Miske, M.S., O.T.R./L

  • Occupational Therapist
  • Centerport, NY
National Provider Identifier
1952850141
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
008781-1 Issued in NY
Practice address
27 Cranbrook CT
Centerport, NY 11721-1769
Phone
(631) 902-5597
NPI assigned
Sep 28, 2016
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 008781-1 NY Primary

Addresses

Primary practice location

27 Cranbrook CT
Centerport, NY 11721-1769

Mailing address

27 Cranbrook CT
Centerport, NY 11721-1769
Phone (631) 902-5597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319002138 NY Practitioner - Occupational Therapist in Private Practice 4688936263 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Therapeutics PT and OT PLLCGroup PAC ID 5991977712, 41 clinicians
Matthew Colucci P.T.,P.C.Group PAC ID 9133019771, 5 clinicians

Practice addresses (Care Compare)

1 Huntington Quadrangle
Suite 1S07
Melville, NY 11747-4426
Phone (516) 222-2010

15 Dixie LN
East Islip, NY 11730-2518
Phone (516) 380-8450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
008781-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Colucci P.T.,P.C. CurrentSince Nov 2, 2020 Accepting new patients
B Stern Physical Therapy P.C. Occupational Therapist CurrentSince Jan 22, 2018 Accepting new patients
Stern at Home Physical Therapy PC Occupational Therapist CurrentSince Apr 20, 2019 Accepting new patients
Optimum Therapeutics PT & OT PLLC Occupational Therapist CurrentSince Jun 30, 2019 Accepting new patients
Genesis Medical Health PC Past Accepting new patients
Propel Physical Therapy PC Occupational Therapist PastSince Jun 30, 2019 Accepting new patients

Locations

440 Beach 21st St
Far Rockaway, NY 11691
Phone (718) 327-5500

1 Huntington Quadrangle
Ste 1S07
Melville, NY 11747
Phone (516) 222-2010

23 Robert Pitt Dr
Ste 110
Monsey, NY 10952

25 Robert Pitt Dr
Ste 109
Monsey, NY 10952
Phone (845) 625-2818

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1952850141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CRANBROOK CT",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211769",
            "telephone_number": "631-902-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CRANBROOK CT",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211769",
            "telephone_number": "631-902-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISKE",
        "first_name": "LISA",
        "credential": "M.S., O.T.R./L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "008781-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.