Kyle Buckham, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

60965462 Issued in WA

Practice address

506 12TH Ave
Seattle, WA 98122-5509

Phone

(206) 430-6262

NPI assigned

Jul 2, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manual Therapy International Professional Services PLLCGroup PAC ID 7012808041, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Manual Therapy International Professional Services PLLC

  dba Mti Physical Therapy

  • Physical Therapist
  • Bellevue, WA
  • NPI 1871654475
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1548822208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 E YESLER WAY APT 216",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 12TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225509",
            "telephone_number": "206-430-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHAM",
        "first_name": "KYLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "60965462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ingrid Buck, MD
• Maura Buck, LMP
• Michael Buck
• Stephen David Buck, DDS
• Taylor Buck
• Sara Buckingham
• Sarah Buckingham, MSW
• Stephen Thomas Buckingham
• Heather Buckle, N.D.
• Eric Buckler

• Orthopedic Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Orthopedic Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.