Andrew Paul Bucko, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

J3-0000512 Issued in PA

Practice address

205 S Providence Rd
Wallingford, PA 19086-6333

Phone

(610) 892-3470

NPI assigned

Aug 14, 2019

Last updated

Aug 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Quaker State Medical Services Co Inc

  • Non-Pharmacy Dispensing Site
  • Exton, PA
  • NPI 1629089578
  NPD (past)

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1487200473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PASADENA DR",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491645",
            "telephone_number": "610-717-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S PROVIDENCE RD",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "190866333",
            "telephone_number": "610-892-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 W Sproul Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190642045",
            "country_code": "US",
            "telephone_number": "610-328-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKO",
        "first_name": "ANDREW",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "J3-0000512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000015396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ATHLETIC TRAINING LICENSE",
            "identifier": "J3-0000512",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Baschoff, LSW
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• Katherine Brugger, LPC
• Janet Buckley, DIRECT ACCESS P.T.
• Cardiovascular Group LLC
• Carelink Community Support Services
• Carelink Community Support Services of Pennsylvania Inc
• Yuh Teh Chen, M.D.
• Joseph P Cheruka, DMD

• Athletic Trainer in Wallingford, PA
• Providers in Wallingford, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.