NPIMap

Individual provider Active NPI

Michael Gurdon Buck, M.D.

  • Family Medicine Physician
  • Alexandria, LA
National Provider Identifier
1063402667
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
015029 Issued in LA
Practice address
1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4217
Phone
(318) 473-4500
Fax
(318) 445-1509
NPI assigned
Oct 25, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 015029 LA Primary

Addresses

Primary practice location

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4217

Mailing address

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4217
Phone (318) 473-4500

Other identifiers 2

IdentifierTypeStateIssuer
5J260OtherMEDICARE PTAN
1318469MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000806 LA Practitioner - Family Practice 2567425556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cenla Family Medicine Associates, LLCGroup PAC ID 7517010705, 18 clinicians

Practice addresses (Care Compare)

1587 N Bolton Ave
Suite 1100
Alexandria, LA 71303-4255
Phone (318) 445-9823

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015029LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cenla Family Medicine Associates, LLC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Lsumc-S Family Practice Medical Family Medicine CurrentSince Sep 1, 1997 Accepting new patients
Rapides Healthcare System, L.L.C. Past Accepting new patients
Louisiana Special Education Center Past Accepting new patients

Locations

1587 N Bolton Ave
Ste 1100
Alexandria, LA 71303
Phone (318) 445-9823

301 4th St
Alexandria, LA 71301
Phone (318) 441-1030

301 4th St
Ste 30123
Alexandria, LA 71301

301 4th St
Ste 30124
Alexandria, LA 71301
Phone (318) 445-9823

301 4th St
Ste A
Alexandria, LA 71301
Phone (318) 441-1030

821 Elliott St
Alexandria, LA 71301
Phone (318) 441-1030

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEDCAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CEDCAA/Endpoint/CEDCAA

Organizations & group practices 4

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.

Hospital & facility affiliations 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1063402667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE",
            "address_2": "SUITE 1100",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034217",
            "telephone_number": "318-473-4500",
            "fax_number": "318-445-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE",
            "address_2": "SUITE 1100",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034217",
            "telephone_number": "318-473-4500",
            "fax_number": "318-445-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MICHAEL",
        "middle_name": "GURDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "015029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5J260",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1318469",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.