Individual provider Active NPI

Jody-Ann Roxanne Buckle, F.N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1295043032
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F406937 Issued in NY
Practice address
PO Box 1876
White Plains, NY 10602-1876
Phone
(914) 734-5122
Fax
(309) 329-5154
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F406937 NY Primary
Family Nurse Practitioner 363LF0000X F336465 NY

Addresses

Primary practice location

PO Box 1876
White Plains, NY 10602-1876

Mailing address

PO Box 1876
White Plains, NY 10602-1876
Phone (914) 734-5122

Other practice location 1

2626 Halperin Ave
Bronx, NY 10461-2631
Phone (914) 734-5122

Other identifiers 1

IdentifierTypeStateIssuer
03404877MedicaidNY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000311 NY Practitioner - Nurse Practitioner 1759556657 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medagent CorpGroup PAC ID 4789900796, 27 clinicians
Peyman Younesi MD PLLCGroup PAC ID 4981860202, 98 clinicians

Practice addresses (Care Compare)

7 Croton Ave
Cortlandt Manor, NY 10567-5203
Phone (914) 962-5800

7810 164TH St
Fresh Meadows, NY 11366-1229
Phone (718) 709-0940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336465NYMDFamily Nurse Practitioner
F406937NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Peyman Younesi MD PLLC CurrentSince Aug 15, 2024 Accepting new patients
Medagent Corp CurrentSince Mar 3, 2026 Accepting new patients
My Medical PC CurrentSince Sep 1, 2024 Accepting new patients
Statline Medical PC CurrentSince Jan 5, 2025 Accepting new patients
Middlesex Psychiatry & TMS PC Past Accepting new patients

Locations

3438 Bell Blvd
Ste 301
Bayside, NY 11361

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

2830 Pitkin Ave
Brooklyn, NY 11208
Phone (347) 420-8295

7 Croton Ave
Cortlandt Mnr, NY 10567
Phone (914) 962-5800

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

9131 175th St
Jamaica, NY 11432
Phone (340) 709-3133

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

451 Broad St
Salamanca, NY 14779
Phone (716) 945-1800

297 N Ballston Ave
Scotia, NY 12302
Phone (518) 370-4700

200 White Plains Rd
Ste 110
Tarrytown, NY 10591
Phone (914) 848-4343

Organizations & group practices 8

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1295043032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1876",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106021876",
            "telephone_number": "914-734-5122",
            "fax_number": "309-329-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1876",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106021876",
            "telephone_number": "914-734-5122",
            "fax_number": "309-329-5154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2626 Halperin Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612631",
            "country_code": "US",
            "telephone_number": "914-734-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLE",
        "first_name": "JODY-ANN",
        "middle_name": "ROXANNE",
        "name_prefix": "Ms.",
        "credential": "F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406937",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03404877",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.