Individual provider Active NPI

Jose Hayag Buco, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1811923618
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013152-1 Issued in NY
Practice address
110 Ocean Pkwy
Professional Suite a
Brooklyn, NY 11218-2457
Phone
(718) 854-9055
Fax
(718) 854-9121
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 013152-1 NY Primary

Addresses

Primary practice location

110 Ocean Pkwy
Professional Suite a
Brooklyn, NY 11218-2457

Mailing address

110 Ocean Pkwy a
Brooklyn, NY 11218-2492
Phone (718) 854-9055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215001047 NY Practitioner - Physical Therapist in Private Practice 8527025071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013152NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Physical Therapy, PC Physical Therapist CurrentSince Mar 4, 1996 Accepting new patients
Quality Care Physical Therapy, PC Physical Therapist Past Accepting new patients
Quality Care Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

110 Ocean Pkwy
Ste A
Brooklyn, NY 11218
Phone (718) 854-9055

32 E 37th St
New York, NY 10016
Phone (212) 365-8788

Organizations & group practices 3

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1811923618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OCEAN PKWY A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182492",
            "telephone_number": "718-854-9055",
            "fax_number": "718-854-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OCEAN PKWY",
            "address_2": "PROFESSIONAL SUITE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182457",
            "telephone_number": "718-854-9055",
            "fax_number": "718-854-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCO",
        "first_name": "JOSE",
        "middle_name": "HAYAG",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013152-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.