Individual provider Active NPI

Maria L Buckley, PHD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1487632634
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS00761 Issued in RI
Practice address
1 Hoppin St
Coro Center, 3Rd Floor
Providence, RI 02903-4141
Phone
(401) 793-8770
NPI assigned
Jan 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS00761 RI Primary

Addresses

Primary practice location

1 Hoppin St
Coro Center, 3Rd Floor
Providence, RI 02903-4141

Mailing address

PO Box 3238
Boston, MA 02241-3238
Phone (866) 689-8862

Other identifiers 2

IdentifierTypeStateIssuer
26355-1OtherRIBCBS RI
409415OtherRIBLUECHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000622 RI Practitioner - Clinical Psychologist 3375520513 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

146 W River St
Providence, RI 02904-2609

593 Eddy St
Providence, RI 02903-4923

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Jul 24, 2025 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince Mar 29, 2015 Accepting new patients
Rhode Island Hospital Clinical CurrentSince Jul 24, 2025 Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2004 Accepting new patients
The Miriam Hospital Clinical CurrentSince Jan 1, 2004 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

1 Hoppin St
Ste 3
Providence, RI 02903
Phone (401) 793-8400

146 W River St
#11A
Providence, RI 02904
Phone (401) 606-8250

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Interoperability endpoints

  • Direct secure messaging: mbuckley14036@brownhealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1136592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1487632634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3238",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022413238",
            "telephone_number": "866-689-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST",
            "address_2": "CORO CENTER, 3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-793-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MARIA",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-07",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RI",
            "identifier": "26355-1",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP",
            "identifier": "409415",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.