Individual provider Active NPI

Diane Walker Bucknill, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1376578658
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
123257 Issued in MA
Practice address
Senior Health Unit, CP2 502
165 Cambridge St
Boston, MA 02114
Phone
(617) 726-4600
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 123257 MA Primary

Addresses

Primary practice location

Senior Health Unit, CP2 502
165 Cambridge St
Boston, MA 02114

Mailing address

Senior Health Unit, CP2 502
165 Cambridge St
Boston, MA 02114
Phone (617) 726-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, NJ, MI, PA, DE6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20050111000728 MA Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 4 organizations
I20170412001549 NH Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 1 organization
I20221107000224 NJ Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 2 organizations
I20221230002169 MI Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 2 organizations
I20230130000019 PA Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 2 organizations
I20230130000046 DE Practitioner - Nurse Practitioner 0143278606 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
123257MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Post-Acute Medical Services 1 PC CurrentSince Oct 1, 2022 Accepting new patients
Massachusetts Post Acute Medical Services 1 PC CurrentSince Nov 1, 2017 Accepting new patients
Ipc Hospitalists of New England, P.C. Nurse Practitioner CurrentSince Sep 30, 2013 Accepting new patients
Inpatient Consultants of Pennsylvania PC Nurse Practitioner CurrentSince Jan 23, 2023 Accepting new patients
De Pacs 2 PA CurrentSince Feb 1, 2023 Accepting new patients
Ma Pacs 2 PC CurrentSince Sep 11, 2020 Accepting new patients
Delaware Post Acute Medical Services 1 CurrentSince Feb 1, 2023 Accepting new patients
Massachusetts Acute Care Specialists PC CurrentSince Jul 1, 2017 Accepting new patients
Mi Pacs 2 PC CurrentSince Oct 1, 2022 Accepting new patients
Inpatient Consultants of Pennsylvania PC CurrentSince Jan 23, 2023 Accepting new patients
NJ Pacs 2 PA CurrentSince Jul 19, 2022 Accepting new patients
New Jersey Post Acute Medical Services 1 PA CurrentSince Jul 19, 2022 Accepting new patients
Ipc Hospitalists of New England PC Nurse Practitioner CurrentSince Sep 30, 2013 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Past Accepting new patients
NV Pacs 2 LLC Past Accepting new patients

Locations

810 S Broom St
Wilmington, DE 19805
Phone (302) 234-5420

700 Foulk Rd
Wilmington, DE 19803
Phone (302) 328-1582

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

111 Birch St
Lynn, MA 01902
Phone (781) 592-9667

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

37 State Highway 6A
Sandwich, MA 02563
Phone (508) 888-8222

819 Worcester St
Ste 3
Springfield, MA 01151
Phone (413) 543-6820

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

555 Highland Ave
Milford, MI 48381
Phone (248) 684-1564

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

71 Elm St
Milford, NH 03055
Phone (603) 673-2907

55 Harris Rd
Nashua, NH 03062
Phone (603) 324-4415

95 Mount Kemble Ave
Morristown, NJ 07960
Phone (973) 971-4451

77 Madison Ave
Morristown, NJ 07960
Phone (973) 540-9800

1237 W Sherman Ave
Vineland, NJ 08360
Phone (856) 223-7718

2600 Belmont Ave
Philadelphia, PA 19131
Phone (215) 581-0705

720 Blackburn Rd
Sewickley, PA 15143
Phone (412) 741-6600

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1376578658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SENIOR HEALTH UNIT, CP2 502",
            "address_2": "165 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SENIOR HEALTH UNIT, CP2 502",
            "address_2": "165 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNILL",
        "first_name": "DIANE",
        "middle_name": "WALKER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "123257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.