Active NPI
Kyle Callis Bugg II, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1639234305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21273
- Practice address
- 156 5TH Ave Ste 822
New York, NY 10010-7765 - Phone
- (212) 256-1697
- Fax
- (646) 792-3850
- NPI assigned
- Dec 23, 2006
- Last updated
- Dec 22, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY21273 | CA | Primary |
Addresses
Primary practice location
156 5TH Ave Ste 822
New York, NY 10010-7765
Mailing address
156 5TH Ave Ste 822
New York, NY 10010-7765
Phone (212) 256-1697
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21273 | CA | MD | Clinical Psychologist |
| 020929-1 | NY | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyle Bugg PSYD and Associates | Current | Accepting new patients |
Locations
156 5th Ave
Ste 822
New York, NY 10010
Phone (212) 256-1697
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1710690664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1639234305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 5TH AVE STE 822",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100107765",
"telephone_number": "212-256-1697",
"fax_number": "626-209-1194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 5TH AVE STE 822",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100107765",
"telephone_number": "212-256-1697",
"fax_number": "646-792-3850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUGG",
"first_name": "KYLE",
"middle_name": "CALLIS",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-23",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.