NPIMap

Individual provider Active NPI

Matthew Buckler, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1063670503
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2559651 Issued in NY
Practice address
59 Executive Park Dr.
Atlanta, GA 30329
Phone
(850) 597-0886
NPI assigned
May 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2559651 NY Primary

Addresses

Primary practice location

59 Executive Park Dr.
Atlanta, GA 30329

Mailing address

27005 76TH Ave
Department of Radiology, Long Island Jewish Medical Cen
New Hyde Park, NY 11040-1402
Phone (718) 470-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130723000706 GA Practitioner - Diagnostic Radiology 7719128446 Reassigns benefits to 2 organizations
I20140908002663 FL Practitioner - Diagnostic Radiology 7719128446 Reassigns benefits to 4 organizations
Practice locations: Orlando, FL; Kissimmee, FL; Altamonte Springs, FL
I20241210000082 WI Practitioner - Diagnostic Radiology 7719128446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians

Practice addresses (Care Compare)

1818 Homestead Ave NE
Atlanta, GA 30306-3136
Phone (614) 340-7740

9281 NW 57TH St
Apt 205
Tamarac, FL 33351-4375
Phone (614) 340-7740

Hospital & facility affiliations

  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2559651NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Feb 1, 2024 Accepting new patients
Dean Health Systems, Inc CurrentSince Nov 4, 2024 Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Florida United Radiology LC Diagnostic Radiology Current Accepting new patients
Madison Radiologists S C Diagnostic Radiology CurrentSince Sep 24, 2024 Accepting new patients
Sheridan Radiology Services of Pinellas, Inc. Diagnostic Radiology Current Accepting new patients
Dean Health Systems, Inc. CurrentSince Nov 4, 2024 Accepting new patients
Sheridan Radiology Services of Central Florida Inc Diagnostic Radiology Current Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology PastSince Jan 24, 2026 Accepting new patients

Locations

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Networks

  • Freedom Health HMO Network

Organizations & group practices 10

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1063670503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY, LONG ISLAND JEWISH MEDICAL CEN",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK DR.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "850-597-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLER",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2559651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.