Jonah Buczewski

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3640 Colonel Glenn Hwy
Dayton, OH 45435-0001

Phone

(484) 663-3301

NPI assigned

Sep 14, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• National Youth Advocate Program, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1841943495

  Community/Behavioral Health

  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1295340412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "484-663-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "484-663-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 E Livingston Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155533",
            "country_code": "US",
            "telephone_number": "614-227-9420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCZEWSKI",
        "first_name": "JONAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "buczewski.2@wright.edu",
            "affiliation": "Y",
            "affiliationName": "Wright State University",
            "address_1": "3640 Colonel Glenn Hwy",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454350001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Buckeye Homehealthcare of Ohio Inc
• Buckeye Senior Rehab LLC
• Jared Buckingham
• Lisa Buckingham, CRNA
• Jessica Rae Buczek, MS, LPCC
• Paul James Budak, LPN
• James A Budde III, D.D.S.
• Shirley Jean Budding, CNS, BC
• Valerie Budervic, PSY.D.
• Lita R Budiamal, MD

• All providers in Dayton, OH
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.