Individual provider Active NPI

Kyle Callis Bugg II, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1639234305
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21273 Issued in CA
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, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PSY21273CAMDClinical Psychologist
020929-1NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle Bugg PSYD and Associates CurrentSince Dec 24, 2023 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.

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.

Verify at the official NPI Registry.