Individual provider Active NPI

Lynn Randolph Buckner, MD

  • Surgery Physician
  • Decatur, AL
National Provider Identifier
1386694263
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00016036 Issued in AL
Practice address
1405 7TH Street SE
Decatur, AL 35601-3341
Phone
(256) 355-6414
Fax
(256) 355-6646
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 00016036 AL Primary

Addresses

Primary practice location

1405 7TH Street SE
Decatur, AL 35601-3341

Mailing address

PO Box 1029
Decatur, AL 35602-1029
Phone (256) 355-6414

Other identifiers 4

IdentifierTypeStateIssuer
000025530MedicaidAL
1710268OtherALUNITED HEALTH
51025530BUCOtherALBCBS
990010719OtherALRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110118000300 AL Practitioner - General Surgery 4789664087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of N AlabamaGroup PAC ID 4789607268, 5 clinicians

Practice addresses (Care Compare)

1405 7TH St SE
Decatur, AL 35601-3341
Phone (256) 355-6414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.17 of 100Reported as group
Quality
100
Promoting interoperability
97
Improvement activities
40
Cost
75.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)18
Mastectomy13
Melanoma (skin cancer) excision42
Removal of tissue17
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00016036ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of N Alabama Surgery CurrentSince Feb 11, 1997 Accepting new patients

Locations

1405 7th St SE
Decatur, AL 35601
Phone (256) 355-6414

Interoperability endpoints

  • Direct secure messaging: lrandolphbuckner@sana.allscriptsdirect.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1386694263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356021029",
            "telephone_number": "256-355-6414",
            "fax_number": "256-355-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 7TH STREET SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013341",
            "telephone_number": "256-355-6414",
            "fax_number": "256-355-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "LYNN",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "00016036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000025530",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "1710268",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51025530BUC",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "990010719",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.