Individual provider Active NPI

Brooke Bucinell, RD,CDCES

  • Registered Dietitian
  • Albany, NY
National Provider Identifier
1245808104
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86076678
Practice address
63 Shaker Rd Ste 201
Albany, NY 12204-1030
Phone
(518) 471-3636
Fax
(518) 471-3668
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86076678 Primary

Addresses

Primary practice location

63 Shaker Rd Ste 201
Albany, NY 12204-1030

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

855 Route 146 Ste 150
Clifton Park, NY 12065-3874
Phone (518) 471-3636

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211007002273 NY Practitioner - Registered Dietitian Or Nutrition Professional 4789082637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

63 Shaker Rd
Suite 201
Albany, NY 12204-1030
Phone (518) 471-3636

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010090NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Jul 13, 2021 Accepting new patients
Albany Medical College Current Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Dietitian, Registered CurrentSince Jan 6, 2025 Accepting new patients
Albany Medical College Dietitian, Registered CurrentSince Jul 13, 2021 Accepting new patients
Albany Medical College CurrentSince Jul 13, 2021 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Past Accepting new patients

Locations

25 Hackett Blvd
Albany, NY 12208
Phone (518) 262-1200

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

855 Route 146
Ste 150
Clifton Park, NY 12065
Phone (518) 292-6200

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1245808104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHAKER RD STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041030",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Route 146 Ste 150",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653874",
            "country_code": "US",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCINELL",
        "first_name": "BROOKE",
        "credential": "RD,CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86076678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "63 Shaker Rd Ste 201",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122041030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.