Active NPI
Shane Michael Bucher, DPT
- Physical Therapist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT030337
- Practice address
- 1528 Walnut St Ste 1210
Philadelphia, PA 19102-3609 - Phone
- (215) 839-0989
- Fax
- (215) 600-2228
- NPI assigned
- Dec 6, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60314774 | WA | |
| Physical Therapist | 225100000X | 038924 | NY | |
| Physical Therapist | 225100000X | PT030337 | PA | Primary |
Addresses
Primary practice location
1528 Walnut St Ste 1210
Philadelphia, PA 19102-3609
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050
Other practice location 1
1655 Elmwood Ave Ste 130
Rochester, NY 14620
Phone (585) 442-9110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1919 Chestnut St
Suite 104
Philadelphia, PA 19103-3456
Phone (215) 564-1110
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038924 | NY | MD | Clinical Social Worker |
| PT030337 | PA | MD | Physical Therapist |
| PT60314774 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic and Sports Physical Therapy Services, Inc. | Physical Therapist | Current | Accepting new patients |
| Progress Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
Locations
1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838
1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282
1919 Chestnut St
Ste 104
Philadelphia, PA 19103
Phone (215) 564-1110
517 S 4th St
Philadelphia, PA 19147
Phone (215) 629-1270
1528 Walnut St
Ste 1210
Philadelphia, PA 19102
Phone (215) 839-0989
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.
-
- Physical Therapist
- Philadelphia, PA
- NPI 1164851085
-
- Physical Therapist
- Philadelphia, PA
- NPI 1588661235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1336484062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224",
"telephone_number": "914-294-4050",
"fax_number": "631-760-8306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1528 WALNUT ST STE 1210",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023609",
"telephone_number": "215-839-0989",
"fax_number": "215-600-2228"
}
],
"practiceLocations": [
{
"address_1": "1655 Elmwood Ave Ste 130",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "14620",
"country_code": "US",
"telephone_number": "585-442-9110",
"fax_number": "585-442-9049",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUCHER",
"first_name": "SHANE",
"middle_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-06",
"last_updated": "2022-05-05",
"certification_date": "2022-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60314774",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "038924",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT030337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.