Individual provider Active NPI

Alexis Buckley, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Hollywood, FL
National Provider Identifier
1447633292
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME175099 Issued in FL
Practice address
1201 N 35TH Ave Ste 200
Hollywood, FL 33021-5434
Phone
(954) 987-8100
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X ME175099 FL Primary

Addresses

Primary practice location

1201 N 35TH Ave Ste 200
Hollywood, FL 33021-5434

Mailing address

9350 The Resort Pkwy Unit 5811
Rancho Cucamonga, CA 91730-9245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230626000704 MA Practitioner - Plastic and Reconstructive Surgery 1153668496 Reassigns benefits to 2 organizations
I20250827001052 FL Practitioner - Plastic and Reconstructive Surgery 1153668496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yoav Barnavon MD PAGroup PAC ID 8527252964, 2 clinicians

Practice addresses (Care Compare)

1201 N 35TH Ave
Suite 200
Hollywood, FL 33021-5434
Phone (954) 987-8100

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME175099FLMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 1, 2023 Accepting new patients
Yoav, Barnavon, MD, PA Plastic and Reconstructive Surgery CurrentSince Sep 1, 2025 Accepting new patients

Locations

1201 N 35th Ave
Ste 200
Hollywood, FL 33021
Phone (954) 501-0505

1201 N 35th Ave
Hollywood, FL 33021
Phone (321) 403-3991

1201 N 35th Ave
#200
Hollywood, FL 33021

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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 1

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1447633292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 THE RESORT PKWY UNIT 5811",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N 35TH AVE STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215434",
            "telephone_number": "954-987-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME175099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.