Individual provider Active NPI

Jeffrey Buckner, MD

  • Hematology (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1104840495
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
143135 Issued in NY
Practice address
274 Madison Ave RM 602
New York, NY 10016-0701
Phone
(212) 689-0040
Fax
(646) 389-4948
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 143135 NY
Hematology (Internal Medicine) Physician 207RH0000X 143135 NY Primary

Addresses

Primary practice location

274 Madison Ave RM 602
New York, NY 10016-0701

Mailing address

274 Madison Avenue
Suite 602
New York, NY 10016
Phone (212) 689-0040

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20041206000035 NY Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0840252581 Practice locations: New York, NY

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jbuckner43672@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104840495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 MADISON AVENUE",
            "address_2": "SUITE 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-689-0040",
            "fax_number": "646-389-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-689-0040",
            "fax_number": "646-389-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "143135",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NY",
            "license": "143135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.