Justin M Buck, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2021006165 Issued in MO

Practice address

3899 Veterans Memorial Pkwy
Saint Peters, MO 63376-6425

Phone

(636) 922-9933

NPI assigned

Mar 4, 2021

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 MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance 21 Physical Therapy LLCGroup PAC ID 4688022528, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Performance 21 Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Arnold, MO
  • NPI 1578336822

  MO, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Advanced Training and Rehab LLC

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1174576045

  MO, Physical Therapist

  Medicare reassignment NPD
• Atr Jeff LLC

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1013313493

  MO, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1487249140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3899 VETERANS MEMORIAL PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766425",
            "telephone_number": "636-922-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 VETERANS MEMORIAL PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766425",
            "telephone_number": "636-922-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021006165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jane Brown, CCC-SLP
• Tanner Michael Brown, DMD
• Elise Caroline Bruenderman, MS CF-SLP
• Shawn K Brunk, DO
• Alexa Danielle Bruno, COTA/L
• Lorena Buffa, MD
• Nicole R Bumhoffer, DC
• Samantha Bunch, APRN FNP-BC
• Hannah Bunster de Almeida, LPC, RPT
• Harry D Burack, MD

• All providers in Saint Peters, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.