Active NPI
Jeffry Thomas Bucyk
- Athletic Trainer
- Salem, MA
National Provider Identifier
1336655851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 390200000X
- Practice address
- 225 Canal St
Salem, MA 01970-4554 - Phone
- (978) 542-2879
- NPI assigned
- Dec 20, 2017
- Last updated
- Dec 20, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 390200000X | MA | Primary |
Addresses
Primary practice location
225 Canal St
Salem, MA 01970-4554
Mailing address
95 Amesbury Rd
Newton, NH 03858-3205
Phone (603) 819-3423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513728000000",
"number": "1336655851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 AMESBURY RD",
"city": "NEWTON",
"state": "NH",
"postal_code": "038583205",
"telephone_number": "603-819-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 CANAL ST",
"city": "SALEM",
"state": "MA",
"postal_code": "019704554",
"telephone_number": "978-542-2879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCYK",
"first_name": "JEFFRY",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-20",
"last_updated": "2017-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.