Individual provider Active NPI

Holly J Reynolds Buchen, PA

  • Physician Assistant
  • Hudson, WI
National Provider Identifier
1477833275
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2835 Issued in WI
Practice address
1610 Maxwell Dr
Hudson, WI 54016-8709
Phone
(715) 389-5278
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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 2835 WI Primary

Addresses

Primary practice location

1610 Maxwell Dr
Hudson, WI 54016-8709

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9016

Other practice location 1

1656 Dorset Ln Ste 400
New Richmond, WI 54017-2449
Phone (715) 246-4624

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Holly.ReynoldsBuchen@forefrontdermatology.emadirect.md
Direct Messaging Address Holly.ReynoldsBuchen@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20111228000776 WI Practitioner - Physician Assistant 3779759592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

1400 Scheuring Rd
De Pere, WI 54115-1067
Phone (920) 964-0229

1610 Maxwell Dr
Suite 210
Hudson, WI 54016-4004
Phone (715) 386-5278

1656 Dorset LN
Suite 400
New Richmond, WI 54017-2449
Phone (715) 246-4624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2835WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Oct 12, 2015 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

1610 Maxwell Dr
Ste 210
Hudson, WI 54016
Phone (715) 385-5278

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: holly.reynoldsbuchen@forefrontdermatology.emadirect.md

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1477833275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9016",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MAXWELL DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168709",
            "telephone_number": "715-389-5278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1656 Dorset Ln Ste 400",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540172449",
            "country_code": "US",
            "telephone_number": "715-246-4624",
            "fax_number": "715-386-5508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS BUCHEN",
        "first_name": "HOLLY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Holly.ReynoldsBuchen@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1610 Maxwell Dr",
            "city": "Hudson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540168709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Holly.ReynoldsBuchen@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1656 Dorset Ln Ste 400",
            "city": "New Richmond",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540172449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.