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JEFFREY MARK LACKNER PSY.D.
NPI 1821293168
Psychologist - Cognitive & Behavioral in Buffalo, NY

Active since June 18, 2007PECOS EnrolledAccepts Medicare Assignment
462 GRIDER ST, ROOM G208, BUFFALO, NY 14215(716) 898-5671(716) 898-3040 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jeffrey Mark Lackner Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY MARK LACKNER PSY.D. (NPI 1821293168) is an individual cognitive & behavioral provider in Buffalo, New York, licensed in New York (012051) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1821293168
Entity TypeIndividualMale
Primary Taxonomy103TB0200X
Provider Legal NameJEFFREY MARK LACKNERCredential: PSY.D.
Location Address462 GRIDER ST, ROOM G208Buffalo, NY 14215-3021
Mailing AddressPo Box 93Amherst, NY 14226-0093 · (716) 898-5671 · Fax (716) 898-3040
Phone(716) 898-5671
Fax(716) 898-3040
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateJune 18, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1821293168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in NY · 012051
Definition
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
462 GRIDER ST, Buffalo, NY 14215
Open in Google Maps ↗

Other Identifiers 5

Other00025302101NY · Univera
Other000523299002NY · Blue Cross
Medicare ID-Type UnspecifiedAA0415NY
OtherDF1724NY · Rr Medicare
Other6108856NY · Iha

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jeffrey Mark Lackner Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153457197
PECOS Enrollment IDI20100330000430
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Lackner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Academic Medicine Services, Inc.
7.0 mi
Internal Medicine
1020 YOUNGS RD
Williamsville, NY 14221
  • Reassigned Medicare billing, New York enrollment
  • 157 clinicians in this Medicare group
NPI 1255394763 (716) 961-9900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. V. THOMAS CHAPIN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000
DR. JOHN JACOB HANNIBAL IV M.D.
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-4226
HMB PHARMACY MANAGEMENT LLC
Pharmacy (Community/Retail Pharmacy)
462 GRIDER ST, DRIVEWAY 3
BUFFALO, NY 14215
Erie County (716) 332-2866
SARAH MARIE THOMPSON PA-C
Physician Assistant
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 698-5375
MATTHEW GARRETT ALBEN DO
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-5053
DANNY ISSAM BELMONA MD
Student in an Organized Health Care Education/Training Program
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000
MR. KENNETH L DZIALAK COTA
Occupational Therapy Assistant
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3575
MS. ZENA SONDRA HYMAN NP
Nurse Practitioner (Adult Health)
462 GRIDER ST
BUFFALO, NY 14215
Erie County (716) 898-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Lackner's NPI number?

The NPI number for Jeffrey Lackner is 1821293168. It was assigned to this individual provider in the NPPES registry on June 18, 2007.

Where is Jeffrey Lackner located?

Jeffrey Lackner practices at 462 Grider St Room G208, Buffalo, NY 14215. The listed phone number is (716) 898-5671.

What is Jeffrey Lackner's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Jeffrey Lackner enrolled in Medicare?

Yes. Jeffrey Lackner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jeffrey Lackner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Lackner reassigns Medicare benefits to Academic Medicine Services, Inc. (Williamsville, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffrey Lackner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeffrey Lackner was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.