JESSICA LEE BORTEL (NPI# 1780028621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780028621 |
| Entity Type | Individual |
| Full Name | JESSICA LEE BORTEL |
| Credential | M.D. |
| Practice Address |
462 Grider St Ecmc, #1184-a Buffalo NY 14215-3021 |
| Mailing Address |
1010 E and West Rd West Seneca NY 14224-3602 |
| Practice Telephone | 7168984221 |
| Practice Fax Number | 7168984538 |
| Mailing Telephone | 7166777109 |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
282829 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
462 GRIDER ST ECMC, #1184-A |
| City | BUFFALO |
| State | NY |
| Zip Code | 14215-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831195395 | Kara Anne Woods | Physician Assistant | 462 Grider St, Buffalo, NY 14215-3098 | 2005-06-21 |
| 1396355095 | Jenna Elizabeth Nassar | Hospitalist | 462 Grider St, Buffalo, NY 14215-3098 | 2020-08-06 |
| 1962010272 | Jannet Li Harkins | Registered Nurse | 462 Grider St, Buffalo, NY 14215-3021 | 2020-07-22 |
| 1831717172 | Toluwanimi Mercy Aladesua | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-07-13 |
| 1568088854 | Elizabeth Ifeyironwa Onyechi | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-06-22 |
| 1285257949 | Jianhua Wu | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-28 |
| 1710500277 | Calvin James Meaney | Pharmacist | 462 Grider St, Buffalo, NY 14215-3098 | 2020-05-19 |
| 1033731963 | Kaylyn Bunz | Counselor | 462 Grider St, Buffalo, NY 14215-3098 | 2020-05-14 |
| 1356963623 | Holly Renee Johnson | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-10 |
| 1023630522 | Kevin Michael Todd | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497366413 | Krista Lea Marita Koskinen | Student in an Organized Health Care Education/Training Program | 462 Grider Street, 11th Floor, Erie County Medical Cent, Buffalo, NY 14215 | 2020-08-13 |
| 1851919112 | Temitope Oluwaseun Ajayi | Student in an Organized Health Care Education/Training Program | 132 Affinity Lane, Buffalo, NY 14215 | 2020-07-13 |
| 1134741986 | Alexandra Lucia Tibil | Student in an Organized Health Care Education/Training Program | 462 Grider Street, Erie County Medical Center David K., Buffalo, NY 14215 | 2020-05-15 |
| 1093336646 | Sanjeevani Tomar | Student in an Organized Health Care Education/Training Program | University At Buffalo-suny, Department of Medicine, 462 Grider Street, Buffalo, NY 14215 | 2020-05-05 |
| 1982225926 | Rohan Pandey | Student in an Organized Health Care Education/Training Program | 462 Grider St. Erie County Medical Center, Buffalo, NY 14215 | 2020-04-30 |
| 1235759911 | Michael William O'donnell | Student in an Organized Health Care Education/Training Program | Erie County Medical Center Dk Miller Building, 462 Grider Street, Buffalo, NY 14215 | 2020-04-22 |
| 1780204883 | Ishwor Sharma | Student in an Organized Health Care Education/Training Program | Ecmc 462, Grider Street, Dk Miller Bldg, First Floor, Room C100-b, Buffalo, NY 14215 | 2020-04-20 |
| 1174142632 | Salman Masood | Student in an Organized Health Care Education/Training Program | 462 Grider Street Buffalo, Ny 14215, Buffalo, NY 14215 | 2020-04-14 |
| 1730718354 | Charles Feng Hua Zhang | Student in an Organized Health Care Education/Training Program | Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215 | 2020-04-06 |
| 1700415650 | Joseph Charles L'huillier | Student in an Organized Health Care Education/Training Program | General Surgery Residency Program, Ecmc, Dk Miller Bdg, 462 Grider Street, Buffalo, NY 14215 | 2020-04-03 |
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| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447577507 | Ritu Goel | Psychiatry & Neurology | 136 N Division St, Apt 409, Buffalo, NY 14203-2235 | 2010-04-29 |
| 1265687651 | Aimee Dora Dipasqua | Psychiatry & Neurology | Millard Fillmore Hopsital, 3 Gates Circle, 8th Floor, Buffalo, NY 14209 | 2008-11-26 |
| 1801020581 | Michael Scott Adragna | Psychiatry & Neurology | 1001 Main St Fl 4, Buffalo, NY 14203-1009 | 2009-05-08 |
| 1053554501 | Gary N Cohen | Psychiatry & Neurology | 3020 Bailey Ave, 2nd Floor, Buffalo, NY 14215-2814 | 2009-04-14 |
| 1205961257 | Ewen M. Macpherson | Psychiatry & Neurology | 3350 Main St, Buffalo, NY 14214-1316 | 2007-02-22 |
| 1174613442 | Jennifer Scarozza | Psychiatry & Neurology | 70 Barker St, Buffalo, NY 14209-2013 | 2006-10-14 |
| 1063501336 | Helen Roberta Aronoff | Psychiatry & Neurology | 462 Grider St, Buffalo, NY 14215-3021 | 2006-10-12 |
| 1811929524 | Shabrin A Haque | Psychiatry & Neurology | 70 Barker St, Buffalo, NY 14209-2013 | 2006-07-06 |
| 1194752931 | Beth A Smith | Psychiatry & Neurology | 3 Gates Cir, 8th Floor, Buffalo, NY 14209-1120 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327611 | Adel Mostafavi, Md PC | Psychiatry & Neurology | 104 W 40th St Rm 400, New York, NY 10018-3692 | 2020-08-17 |
| 1023632015 | Child and Adult Clinical Psychiatry PC | Psychiatry & Neurology | 75 Prospect St Ste 110, Huntington, NY 11743-3320 | 2020-06-04 |
| 1598306441 | Place of Mind Child, Adolescent, and Adult Psychiatry P.C. | Psychiatry & Neurology | 240 Central Park S Apt 2h, New York, NY 10019-1435 | 2019-10-02 |
| 1881102267 | Park Avenue Physicians PC | Psychiatry & Neurology | 5 W 86th St Apt 1b, New York, NY 10024-3663 | 2018-01-19 |
| 1518478080 | Diego G. Calabria Physician P.C. | Psychiatry & Neurology | 366 N Broadway Ste 304, Jericho, NY 11753-2000 | 2017-10-23 |
| 1013426865 | Bebsy Estefan Md PC | Psychiatry & Neurology | 3050 Corlear Ave # Phb, Bronx, NY 10463-5180 | 2017-09-25 |
| 1902281629 | Derek Rudge | Psychiatry & Neurology | 1051 Riverside Dr Rm 235, New York, NY 10032-1007 | 2015-07-23 |
| 1275918096 | Dr Omar Bashayan Physician Pllc | Psychiatry & Neurology | 155 W 68th St Apt 1102, New York, NY 10023-5816 | 2015-07-22 |
| 1740676766 | Maura E Tappen | Psychiatry & Neurology | 1860 South Ave, Rochester, NY 14620-4229 | 2015-04-07 |
| 1194119560 | Krishen Persaud | Psychiatry & Neurology | Stony Brook Psychiatric Associates, Ufpc, Sbumc, Hsc Level 10, Rm.020, Stony Brook, NY 11794-8101 | 2015-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.