Individual provider Active NPI

Teresa Ann Buczek, PH,D.

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1295786390
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001121 Issued in VA
Practice address
1241 Mall Dr
Richmond, VA 23235-4737
Phone
(804) 794-5928
Fax
(804) 379-6385
NPI assigned
May 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810001121 VA Primary

Addresses

Primary practice location

1241 Mall Dr
Richmond, VA 23235-4737

Mailing address

1241 Mall Dr
Richmond, VA 23235-4737
Phone (804) 794-5928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091214000773 VA Practitioner - Clinical Psychologist 9032259551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1241 Mall Dr
Richmond, VA 23235-4879
Phone (804) 794-5928

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Buczek & Ehrmantraut PC Clinical CurrentSince Oct 25, 2009 Accepting new patients

Locations

1241 Mall Dr
North Chesterfield, VA 23235
Phone (804) 302-0336

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1295786390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 MALL DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354737",
            "telephone_number": "804-794-5928",
            "fax_number": "804-379-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 MALL DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354737",
            "telephone_number": "804-794-5928",
            "fax_number": "804-379-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZEK",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH,D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.