Individual provider Active NPI

Kathleen Buccieri, PT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1821115486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007694-1 Issued in NY
Practice address
100 Metro Park
Suite 105
Rochester, NY 14623-2610
Phone
(585) 427-7610
Fax
(585) 427-7410
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 007694-1 NY Primary

Addresses

Primary practice location

100 Metro Park
Suite 105
Rochester, NY 14623-2610

Mailing address

9 Brookside Dr
Fairport, NY 14450-2229
Phone (585) 377-2605

Other identifiers 3

IdentifierTypeStateIssuer
RC62007694OtherRICPA
7063209OtherAETNA
7702287OtherMVP

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

State licenses

LicenseStateTypeSpecialty
007694-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821115486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BROOKSIDE DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502229",
            "telephone_number": "585-377-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 METRO PARK",
            "address_2": "SUITE 105",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232610",
            "telephone_number": "585-427-7610",
            "fax_number": "585-427-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCIERI",
        "first_name": "KATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "007694-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RICPA",
            "identifier": "RC62007694",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7063209",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "7702287",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.