Eric A Buccello, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0014887 Issued in CO

Practice address

369 Eldorado Blvd Unit 324
Broomfield, CO 80021-3766

Phone

(623) 255-9520

NPI assigned

Oct 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1356940027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 ELDORADO BLVD UNIT 324",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213766",
            "telephone_number": "623-255-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 ELDORADO BLVD UNIT 324",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213766",
            "telephone_number": "623-255-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCELLO",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0014887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie W. Brown, FNP-C
• Kathy (Kathleen) Kay Brown, MS, CNM
• Noel Brucker, M.D.
• Alice Brunecky, M.D., DABMA
• Erin Brunelle
• Nathan Thomas Bucci, MSN, APRN, FNP-C
• Building Block PT LLC
• Building Blocks Physical Therapy, LLC
• John R Burchinal, DO
• Lizabeth Burke

• Physical Therapy Assistant in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.