Individual provider Active NPI

Neil Buckosh, PA

  • Medical Physician Assistant
  • Aventura, FL
National Provider Identifier
1457577025
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104114 Issued in FL
Practice address
21000 NE 28TH Ave Ste 104
Aventura, FL 33180-1421
Phone
(305) 937-1999
Fax
(305) 931-2071
NPI assigned
Apr 18, 2007
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9104114 FL
Medical Physician Assistant 363AM0700X PA9104114 FL Primary

Addresses

Primary practice location

21000 NE 28TH Ave Ste 104
Aventura, FL 33180-1421

Mailing address

21000 NE 28TH Ave Ste 104
Aventura, FL 33180-1421
Phone (305) 937-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070816000427 FL Practitioner - Physician Assistant 3375635600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stuart J Bernstein M D P aGroup PAC ID 3971491812, 2 clinicians

Practice addresses (Care Compare)

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

21110 Biscayne Blvd
Aventura, FL 33180-1252
Phone (305) 937-4400

21110 Biscayne Boulevard
Suite 405
Aventura, FL 33180-1252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104114FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Med Diagnostic Rehab of South Florida Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1457577025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE STE 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "305-937-1999",
            "fax_number": "305-931-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE STE 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "305-937-1999",
            "fax_number": "305-931-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKOSH",
        "first_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104114",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.