Kyle Derek Obiena Bucane

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

054283 Issued in NY

Practice address

50-15 Beach Channel Dr
New York, NY 11691

Phone

(718) 956-5656

Fax

(347) 829-3888

NPI assigned

Jan 27, 2025

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

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.

• Physical Care PT PC

  • Physical Medicine & Rehabilitation Physician
  • Richmond Hill, NY
  • NPI 1295449049

  Physical Therapist

  NPD
• Theradynamics Rehab. PT, OT & SLP, PLLC

  • Physical Therapy Clinic/Center
  • Bronx, NY
  • NPI 1912463399

  Physical Therapist

  NPD

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774137600000",
    "number": "1790597698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50-15 BEACH CHANNEL DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50-15 BEACH CHANNEL DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-956-5656",
            "fax_number": "347-829-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCANE",
        "first_name": "KYLE DEREK",
        "middle_name": "OBIENA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Liza Buan-Jacomina, OPTICIAN
• Quenton Rashawn Bubb, MD, PHD
• Tania Nicole Bubb, PHD, RN
• Rachel Sarah Bubly, MD
• Ashley Bubolo
• Josselin Ana Bucaro
• Sarah Bucaro, LMSW
• Gabriela Bucay
• Anisa Buccellato
• John J Buccellato, MD

• 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 Mar 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.