Juancarlos Buller, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

A66601 Issued in CA

Practice address

300 Hartle CT
Napa, CA 94559-4078

Phone

(707) 254-1775

Fax

(707) 254-1779

NPI assigned

Mar 17, 2006

Last updated

Sep 1, 2021By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbuller675517@direct.ochin.org

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.

• Ole Health

  • Federally Qualified Health Center (FQHC)
  • Napa, CA
  • NPI 1700976503
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• JC Buller MD & Am Clarke MD Inc

  • Family Medicine Physician
  • Napa, CA
  • NPI 1558543272
  NPD (past) Authorized official
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • Fairfield, CA
  • NPI 1245043165
  NPD
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • Napa, CA
  • NPI 1609170695
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • Saint Helena, CA
  • NPI 1295913366
  NPD (past)
• Ole Health

  dba CommuniCare OLE

  • Federally Qualified Health Center (FQHC)
  • Davis, CA
  • NPI 1558366823
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence Queen of the Valley Medical Center

  • Rehabilitation Hospital Unit
  • Napa, CA
  • NPI 1609947282
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1346219557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 PEAR TREE LN STE 100",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586485",
            "telephone_number": "707-254-1770",
            "fax_number": "707-254-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HARTLE CT",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945594078",
            "telephone_number": "707-254-1775",
            "fax_number": "707-254-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLER",
        "first_name": "JUANCARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A66601",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A66601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "00A666010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Lynn Buchanan, RN
• Lori Buckley, PSY.D
• Rachel Bugbee
• William Bugnosen, LVN
• Lisa Phuong Lien Bui, PHARMD
• Daniel H. Bunnell, MD
• Priscilla Burch
• Makayla Rachelle Burke
• Danielle Burkett, BSW
• Amy Ellen Burkhart, MD, RD

• Sports Medicine (Family Medicine) Physician in Napa, CA
• Providers in Napa, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.