Individual provider Active NPI

Dennis Robert Buckley, DC

  • Chiropractor
  • Whittier, CA
National Provider Identifier
1043391485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
22608 Issued in CA
Practice address
16200 E Amber Valley Drive
Whittier, CA 90604
Phone
(562) 947-8755
Fax
(562) 902-3332
NPI assigned
Oct 18, 2006
Sex
Male
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
Chiropractor 111N00000X 22608 CA Primary

Addresses

Primary practice location

16200 E Amber Valley Drive
Whittier, CA 90604

Mailing address

16200 E Amber Valley Drive
Whittier, CA 90604
Phone (562) 947-8755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628001028 CA Practitioner - Chiropractic 3476599697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Advantage Health and Wellness CenterGroup PAC ID 6800935339, 2 clinicians

Practice addresses (Care Compare)

1450 N Lake Ave
Pasadena, CA 91104-2301
Phone (626) 798-7805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22608CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Advantage Health and Wellness Center Chiropractor CurrentSince Mar 1, 2009 Accepting new patients
Health Advantage Physical Medicine Inc CurrentSince May 24, 2015 Accepting new patients
Southern California University of Health Sciences Chiropractor Past Accepting new patients

Locations

1450 N Lake Ave
Pasadena, CA 91104
Phone (626) 564-4240

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043391485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16200 E AMBER VALLEY DRIVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "90604",
            "telephone_number": "562-947-8755",
            "fax_number": "562-902-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16200 E AMBER VALLEY DRIVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "90604",
            "telephone_number": "562-947-8755",
            "fax_number": "562-902-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "DENNIS",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "22608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

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.
  • 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.