Active NPI
Yvonne Marcia Buckner, PA
- Medical Physician Assistant
- Middletown, NY
National Provider Identifier
1538209168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 002081
- Practice address
- 707 E Main St
Middletown, NY 10940-2650 - Phone
- (845) 333-3370
- Fax
- (845) 333-3372
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 002081 | NY | Primary |
Addresses
Primary practice location
707 E Main St
Middletown, NY 10940-2650
Mailing address
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-3370
Other practice location 1
68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04549813 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ybuckner44459@direct.garnethealth.org | Garnet Health Doctors PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002081 | NY | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1538209168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-3370",
"fax_number": "845-333-3372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-3370",
"fax_number": "845-333-3372"
}
],
"practiceLocations": [
{
"address_1": "68 Harris Bushville Rd",
"address_purpose": "LOCATION",
"city": "Harris",
"state": "NY",
"postal_code": "12742",
"country_code": "US",
"telephone_number": "845-333-8484",
"fax_number": "845-794-5675",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUCKNER",
"first_name": "YVONNE",
"middle_name": "MARCIA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2023-11-27",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "002081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04549813",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ybuckner44459@direct.garnethealth.org",
"affiliation": "Y",
"affiliationName": "Garnet Health Doctors PC",
"address_1": "707 E Main St",
"city": "Middletown",
"state": "NY",
"country_code": "US",
"postal_code": "109402650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.