Kailey Marie Buczek, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT41945 Issued in FL

Practice address

253 Granada Dr Ste D
San Luis Obispo, CA 93401-7340

Phone

(805) 543-2244

NPI assigned

Nov 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Central Coast Home Health Inc

  • Home Health Agency
  • San Luis Obispo, CA
  • NPI 1609044924
  NPD (past)
• Central Coast Home Health, Inc.

  • Long Term Care Pharmacy
  • San Luis Obispo, CA
  • NPI 1376998401
  NPD (past)

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1689497810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 LAKERIDGE CT APT 230",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078610",
            "telephone_number": "215-791-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 GRANADA DR STE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017340",
            "telephone_number": "805-543-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZEK",
        "first_name": "KAILEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23560",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Ann Buchanan, OT/L
• Louise Bryden Buck, M.D.
• Laura Lea Buckert, BSRN, PHN
• Coleen Buckley, LCSW
• Lillian V. Bucton, L.C.S.W.
• Stephanie Buenafe, BCBA
• Gabriella Buitrago
• Courtney N. Bundren
• Jason Bunker, OD
• Jodi Rae Burdick, R.D.A.

• Physical Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.