Individual provider Active NPI

Christopher M Buck, MD

  • Family Medicine Physician
  • Old Town, ME
National Provider Identifier
1174628440
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12418 Issued in ME
Practice address
242 Brunswick Street
Old Town, ME 04468-1613
Phone
(207) 827-6128
Fax
(207) 827-6605
NPI assigned
Sep 13, 2006
Last updated
May 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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 MD12418 ME Primary

Addresses

Primary practice location

242 Brunswick Street
Old Town, ME 04468-1613

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247

Other identifiers 1

IdentifierTypeStateIssuer
234280099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20040721001317 ME Practitioner - Family Practice 8729068697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

242 Brunswick St
Old Town, ME 04468-1613
Phone (207) 827-6128

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Nov 1, 2004 Accepting new patients
Penobscot Community Health Center Current Accepting new patients
Penobscot Community Health Center CurrentSince Nov 1, 2004 Accepting new patients
Penobscot Community Health Center Past Accepting new patients

Locations

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

1048 Union St
Ste 5
Bangor, ME 04401
Phone 2079455247436

242 Brunswick St
Old Town, ME 04468
Phone (207) 827-6128

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1174628440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 BRUNSWICK STREET",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681613",
            "telephone_number": "207-827-6128",
            "fax_number": "207-827-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD12418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234280099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Town, ME

Sources for this page

Verify at the official NPI Registry.