Individual provider Active NPI

Annette Marie Bucci, MSPT, CERT-MDT

  • Physical Therapist
  • Latham, NY
National Provider Identifier
1306894266
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018842-1 Issued in NY
Practice address
1182 Troy Schenectady Rd
Suite LL02
Latham, NY 12110-1000
Phone
(518) 220-9705
Fax
(518) 220-9651
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018842-1 NY Primary

Addresses

Primary practice location

1182 Troy Schenectady Rd
Suite LL02
Latham, NY 12110-1000

Mailing address

42 Saratoga Rd
Scotia, NY 12302-3412
Phone (518) 399-6861

Other identifiers 1

IdentifierTypeStateIssuer
02252160MedicaidNY

Other names 1

  • Annette Marie Smith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000218 NY Practitioner - Physical Therapist in Private Practice 6305871872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18842NYMDAddiction (Substance Use Disorder) Counselor
018842NYMDCognitive & Behavioral Psychologist
018842-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Associates of Schenectady, P.C. Physical Therapist Current Accepting new patients
Physical Therapy Associates of Schenectady, P.C. Physical Therapist CurrentSince Jul 7, 2010 Accepting new patients
Physical Therapy Associates of Schenectady, PC Physical Therapist CurrentSince Jul 7, 2010 Accepting new patients
Sports Therapy Albany P.T, P.C. Physical Therapist PastSince Dec 1, 2000 Accepting new patients

Locations

220 Church Ave
Ballston Spa, NY 12020
Phone (518) 399-0062

1182 Troy Schenectady Rd
Ste LL02
Latham, NY 12110
Phone (518) 220-9705

42 Saratoga Rd
Scotia, NY 12302
Phone (518) 399-6861

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1306894266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SARATOGA RD",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123023412",
            "telephone_number": "518-399-6861",
            "fax_number": "518-399-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 TROY SCHENECTADY RD",
            "address_2": "SUITE LL02",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101000",
            "telephone_number": "518-220-9705",
            "fax_number": "518-220-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCI",
        "first_name": "ANNETTE",
        "middle_name": "MARIE",
        "credential": "MSPT, CERT-MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018842-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02252160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "credential": "MSPT, CERT-MDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.