Individual provider Active NPI

Angela Bucella, PT, DPT

  • Orthopedic Physical Therapist
  • Williamsville, NY
National Provider Identifier
1164067351
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
045083 Issued in NY
Practice address
192 Park Club LN
Williamsville, NY 14221-5270
Phone
(716) 632-9200
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 045083 NY Primary

Addresses

Primary practice location

192 Park Club LN
Williamsville, NY 14221-5270

Mailing address

192 Park Club LN Ste 110
Williamsville, NY 14221-5270
Phone (716) 632-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191223001399 NY Practitioner - Physical Therapist in Private Practice 3072947126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Physical Therapy of New York, P.C.Group PAC ID 4284531674, 83 clinicians

Practice addresses (Care Compare)

285 Delaware Ave
Suite 116
Buffalo, NY 14202-1885
Phone (716) 831-8214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045083NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Physical Therapy, PLLC Orthopedic CurrentSince Jan 26, 2022 Accepting new patients
Sports Physical Therapy of New York, P.C. Orthopedic CurrentSince Dec 14, 2024 Accepting new patients

Locations

285 Delaware Ave
Ste 116
Buffalo, NY 14202
Phone (716) 381-8214

4721 Transit Rd
Depew, NY 14043
Phone (716) 656-1880

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": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1164067351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN STE 110",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215270",
            "telephone_number": "716-632-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215270",
            "telephone_number": "716-632-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCELLA",
        "first_name": "ANGELA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "045083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.