Individual provider Active NPI

Joey Bukai, PMHNP-BC, LMHC, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1699309302
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407127 Issued in NY
Practice address
302 5TH Ave Ste 1103
New York, NY 10001-3604
Phone
(937) 756-6697
NPI assigned
Mar 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 012686 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407127 NY Primary

Addresses

Primary practice location

302 5TH Ave Ste 1103
New York, NY 10001-3604

Mailing address

418 Broadway Ste 4279
Albany, NY 12207-2922
Phone (937) 756-6697

Other practice location 1

418 Broadway Ste 4279
Albany, NY 12207-2922
Phone (937) 756-6697

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
012686NYMDMental Health Counselor
407127NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Light Space Mental Health Counseling and Nurse Practitioner in Psychiatry PLLC Mental Health CurrentSince Apr 23, 2023 Accepting new patients

Locations

418 Broadway
Ste 4279
Albany, NY 12207
Phone (937) 756-6697

302 5th Ave
Ste 1103
New York, NY 10001
Phone (516) 459-2255

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1699309302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE 4279",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "937-756-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 5TH AVE STE 1103",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013604",
            "telephone_number": "937-756-6697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 Broadway Ste 4279",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122072922",
            "country_code": "US",
            "telephone_number": "937-756-6697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUKAI",
        "first_name": "JOEY",
        "credential": "PMHNP-BC, LMHC, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-03",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012686",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407127",
            "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 Jun 9, 2025; 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.