Active NPI
Teresa A. Buckstein, M.D.
- Pediatrics Physician
- Phoenix, AZ
National Provider Identifier
1255384111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 14781
- Practice address
- 2525 E Roosevelt St
Phoenix, AZ 85008-4948 - Phone
- (602) 344-5651
- Fax
- (602) 344-5578
- NPI assigned
- May 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 14781 | AZ | Primary |
Addresses
Primary practice location
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Mailing address
PO Box 5177
Phoenix, AZ 85010-5177
Phone (602) 344-5651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278730 | Medicaid | AS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14781 | AZ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311724800000",
"number": "1255384111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5177",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850105177",
"telephone_number": "602-344-5651",
"fax_number": "602-344-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 E ROOSEVELT ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084948",
"telephone_number": "602-344-5651",
"fax_number": "602-344-5578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKSTEIN",
"first_name": "TERESA",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2011-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "14781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "278730",
"state": "AS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.