Brian Bucalo, M.D

Primary specialty

SpecialistTaxonomy code 174400000X

License

BB1760164 Issued in FL

Practice address

10067 Pines Blvd.
Suite a
Pembroke Pines, FL 33024

Phone

(954) 436-5625

Fax

(954) 436-0115

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Miami, LM Miller School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Cancer Treatment CenterGroup PAC ID 2961451125, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Skin Cancer Treatment Center

  • Specialist
  • Pembroke Pines, FL
  • NPI 1861509234
  Medicare reassignment Care Compare group NPD
• Rube J Pardo MD PHD PA

  • Dermatology Physician
  • Coral Gables, FL
  • NPI 1104882257
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477646172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10067 PINES BLVD.",
            "address_2": "SUITE A",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-436-5625",
            "fax_number": "954-436-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10067 PINES BLVD.",
            "address_2": "SUITE A",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-436-5625",
            "fax_number": "954-436-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCALO",
        "first_name": "BRIAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "BB1760164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald Myron Bruno, EDD, LCSW, MCAP
• William E Bruno Jr., MD
• Bryma Psychiatry and Wellness LLC
• Mindy Brysman
• BSMS Pembroke LLC
• Jason M. Buchwald, M.D.
• Joseph Michael Buckley, D.C.
• Jessica Buckmire
• Shakera Ann Marie Bucknor Ingram
• Brandon Budd

• Specialist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.