Individual provider Active NPI

Stephanie Buckley, M.D.

  • Family Medicine Physician
  • Frederick, MD
National Provider Identifier
1457617664
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0080372 Issued in MD
Practice address
7211 Bank CT
Frederick, MD 21703-8483
Phone
(240) 215-6310
NPI assigned
Apr 2, 2012
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0080372 MD Primary

Addresses

Primary practice location

7211 Bank CT
Frederick, MD 21703-8483

Mailing address

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20151118000059 MD Practitioner - Family Practice 9436459724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frederick Health Hospital IncGroup PAC ID 0446149256, shared by 8 NPIs, 127 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone (240) 215-6310

3430 Worthington Blvd
Frederick, MD 21704-7017
Phone (240) 215-6310

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0080372MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Carroll Health Group, LLC Family Medicine CurrentSince Oct 15, 2015 Accepting new patients
Frederick Health Medical Group LLC Family Medicine Current Accepting new patients
Frederick Health Medical Group LLC CurrentSince Aug 1, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

7211 Bank Ct
Ste 230
Frederick, MD 21703
Phone (240) 415-5020

504 E Ridgeville Blvd
Ste 110
Mount Airy, MD 21771
Phone (301) 829-5906

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

Organizations & group practices 6

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 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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1457617664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-215-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 BANK CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038483",
            "telephone_number": "240-215-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0080372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.