Individual provider Active NPI

John L Buker, M.D.

  • MOHS-Micrographic Surgery Physician
  • Lexington, KY
National Provider Identifier
1457355174
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
30380 Issued in KY
Practice address
3475 Richmond Rd
Ste 200
Lexington, KY 40509-2500
Phone
(859) 296-4400
Fax
(859) 296-4300
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 30380 KY Primary

Addresses

Primary practice location

3475 Richmond Rd
Ste 200
Lexington, KY 40509-2500

Mailing address

3475 Richmond Rd
Ste 200
Lexington, KY 40509-2500
Phone (859) 296-4400

Other identifiers 3

IdentifierTypeStateIssuer
000000011970OtherKYCHA PROVIDER NUMBER
000000317646OtherKYANTHEM PROVIDER NUMBER
0004122791OtherKYAETNA PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040302000838 KY Practitioner - Dermatology 9739092834 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30380KYMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John L Buker MD PSC Current Accepting new patients
John L. Buker, M.D., PSC CurrentSince Jan 1, 2004 Accepting new patients

Locations

3475 Richmond Rd
Ste 200
Lexington, KY 40509
Phone (859) 296-4400

880 Corporate Dr
Ste 200
Lexington, KY 40503
Phone (859) 296-4400

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1457355174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 RICHMOND RD",
            "address_2": "STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092500",
            "telephone_number": "859-296-4400",
            "fax_number": "859-296-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 RICHMOND RD",
            "address_2": "STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092500",
            "telephone_number": "859-296-4400",
            "fax_number": "859-296-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKER",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "30380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA PROVIDER NUMBER",
            "identifier": "000000011970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000317646",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "0004122791",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.