Individual provider Active NPI

Caroline Marie Buczynski, PA-C

  • Physician Assistant
  • Teaneck, NJ
National Provider Identifier
1457217283
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00988500 Issued in NJ
Practice address
111 Galway PL
Teaneck, NJ 07666-3640
Phone
(201) 833-9500
NPI assigned
Dec 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00988500 NJ Primary

Addresses

Primary practice location

111 Galway PL
Teaneck, NJ 07666-3640

Mailing address

111 Galway PL
Teaneck, NJ 07666-3640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260513002664 NJ Practitioner - Physician Assistant 3274002829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 Galway PL
Suite 300
Teaneck, NJ 07666-3640

1715 Westover Rd
Clark, NJ 07066-2646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MP00988500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedics &Sports Medicine,PC CurrentSince Mar 30, 2026 Accepting new patients
Hand & Trauma Institute CurrentSince Mar 30, 2026 Accepting new patients

Locations

1255 Broad St
Ste 201A
Bloomfield, NJ 07003
Phone (201) 833-9500

403 Grand Ave
Englewood, NJ 07631
Phone (201) 431-7703

111 Galway Pl
Teaneck, NJ 07666
Phone (201) 833-9500

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": "1766534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1457217283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GALWAY PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GALWAY PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663640",
            "telephone_number": "201-833-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZYNSKI",
        "first_name": "CAROLINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-24",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00988500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.