Yetunde Bucknor, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0075721 Issued in MD

Practice address

220 Girard St Ste 100
Gaithersburg, MD 20877-3467

Phone

(301) 216-0880

Fax

(301) 216-2891

NPI assigned

Aug 30, 2006

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Female

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

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: yetunde.bucknor@ccicares.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Clinic, Inc.

  dba CCI Health Services

  • Federally Qualified Health Center (FQHC)
  • Takoma Park, MD
  • NPI 1790730281

  DC, Pediatrics

  Medicare reassignment NPD
• Community Clinic, Inc

  dba CCI Ora Glen Pharmacy

  • Community/Retail Pharmacy
  • Greenbelt, MD
  • NPI 1295560878
  NPD
• Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gaithersburg, MD
  • NPI 1699817775

  Pediatrics

  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1043320815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103405",
            "telephone_number": "301-340-7525",
            "fax_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GIRARD ST STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208773467",
            "telephone_number": "301-216-0880",
            "fax_number": "301-216-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNOR",
        "first_name": "YETUNDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0075721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nola R Brunache
• Maria Rosa Josephine Bruno, MSW, LMSW
• Dennis Bubar, RPH
• Jane L Buchman, LCSW
• Ana Karina Buckley
• Heather Darlene Buehler, PHARMD
• Monica Chrisel Buhay-Ogilvie, DDS
• Alina Bui, DDS
• Marissa Lian Marinello Bumagny, LMSW
• Gina Buono

• Pediatrics Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.