Individual provider Active NPI

Angeles Michelle Buck, DO

  • Obstetrics & Gynecology Physician
  • Louisville, KY
National Provider Identifier
1306978309
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
03118 Issued in KY
Practice address
4123 Dutchmans LN
Suite 601
Louisville, KY 40207-4707
Phone
(502) 423-9595
Fax
(502) 719-0161
NPI assigned
Mar 12, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 03118 KY Primary

Addresses

Primary practice location

4123 Dutchmans LN
Suite 601
Louisville, KY 40207-4707

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 8

IdentifierTypeStateIssuer
000000724271OtherKYANTHEM -WS
0000571200OtherKYHUMANA - WS
201040620MedicaidIN
50034479OtherKYPASSPORT - WS
7100060270MedicaidKY
03118OtherKYSTATE LICENSE
127009OtherKYSIHO - WS
2668570OtherKYCIGNA-WS

Other names 1

  • Angeles Michelle Lockard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20080929000248 KY Practitioner - Obstetrics/Gynecology 2062589310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

4123 Dutchmans LN
Louisville, KY 40207-4725

4915 Norton Healthcare Blvd
Suite 103
Louisville, KY 40241-2832
Phone (502) 446-6635

4955 Norton Healthcare Blvd
FL 2
Louisville, KY 40241-2832
Phone (502) 394-6350

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03118KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Obstetrics & Gynecology CurrentSince Aug 1, 2011 Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2011 Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

4123 Dutchmans Ln
Ste 601
Louisville, KY 40207
Phone (502) 423-9595

4130 Dutchmans Ln
Ste 400
Louisville, KY 40207
Phone (502) 897-0697

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: abuck15617@direct.nortonhealthcare.org

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306978309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN",
            "address_2": "SUITE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074707",
            "telephone_number": "502-423-9595",
            "fax_number": "502-719-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ANGELES",
        "middle_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "03118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM -WS",
            "identifier": "000000724271",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - WS",
            "identifier": "0000571200",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201040620",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - WS",
            "identifier": "50034479",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100060270",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "03118",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - WS",
            "identifier": "127009",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-WS",
            "identifier": "2668570",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELES",
            "last_name": "LOCKARD",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.