Kyle Tracy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

043822-1 Issued in NY

Practice address

30 Broad St BSMT a
New York, NY 10004-2387

Phone

(646) 790-7454

NPI assigned

Aug 7, 2019

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kellen Ryan Scantlebury Physical Therapy PLLCGroup PAC ID 8325578339, 5 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.

• Kellen Ryan Scantlebury Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Astoria, NY
  • NPI 1659148807

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Fit Club Inc

  • Orthopedic Physical Therapist
  • New York, NY
  • NPI 1225570807

  Single Specialty

  Medicare reassignment NPD
• Spear Physical and Occupational Therapy, LLC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1063454577

  Single Specialty

  Medicare reassignment NPD
• Lake Shore Physical Therapy, P.C.

  • Physical Therapist
  • Ronkonkoma, NY
  • NPI 1871951996

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1710532627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E 32ND ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165595",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST BSMT A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042387",
            "telephone_number": "646-790-7454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4277 Hempstead Tpke Ste 209",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117145706",
            "country_code": "US",
            "telephone_number": "516-731-3587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 E 32nd St Fl 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043822-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Vadakumchery Mental Health Counseling PLLC
• Alyssa Marie Tracy, LMHC
• Gary Tracy, O.D.
• Kathlene Tracy, PH.D.
• Kristen Dawn Rappisi Tracy, PA-C
• William Tracy, MD
• Ferne Traeger, LCSW
• Abigail Trager, MD
• Daniel R. Trager, M.A., L.M.H.C.
• Ella Rose Trager

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.