Individual provider Active NPI

Charles Bucklar Jr., DC

  • Chiropractor
  • Reading, PA
National Provider Identifier
1366416695
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002659L Issued in PA
Practice address
2920 Saint Lawrence Ave
Reading, PA 19606-2233
Phone
(610) 779-7749
Fax
(610) 779-4110
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002659L PA Primary

Addresses

Primary practice location

2920 Saint Lawrence Ave
Reading, PA 19606-2233

Mailing address

2920 Saint Lawrence Ave
Reading, PA 19606-2233
Phone (610) 779-7749

Other identifiers 6

IdentifierTypeStateIssuer
1320044OtherHIGHMARK BLUE SHIELD
3832026OtherAETNA HMO
1001234OtherASHN
7087479OtherAETNA PPO
2012804000OtherINDEPENDENO BLUE CROSSHMO
11446687OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180226000076 PA Practitioner - Chiropractic 2567723059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC002659LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Penn Chiropractic Center P C Chiropractor CurrentSince Jun 13, 2018 Accepting new patients
Alpha Rehabilitation Inc Chiropractor Past Accepting new patients

Locations

3933 Perkiomen Ave
Ste 101
Reading, PA 19606
Phone (610) 401-0598

Organizations & group practices 2

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366416695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SAINT LAWRENCE AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196062233",
            "telephone_number": "610-779-7749",
            "fax_number": "610-779-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 SAINT LAWRENCE AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196062233",
            "telephone_number": "610-779-7749",
            "fax_number": "610-779-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLAR",
        "first_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002659L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1320044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3832026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHN",
            "identifier": "1001234",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7087479",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENO BLUE CROSSHMO",
            "identifier": "2012804000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11446687",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.