Jerrold M Buckaloo, MD

Primary specialty

Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X

License

20903 Issued in SC

Practice address

1175 Cook Rd
Suite 215
Orangeburg, SC 29118-8201

Phone

(803) 395-3837

Fax

(803) 536-5122

NPI assigned

Sep 14, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11118/brand/5/csg/22/fhir/r4

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.

• Valdosta Orthopedic Associates PC

  dba Valdosta Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Valdosta, GA
  • NPI 1053457457

  Hand Surgery

  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1558466516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 215",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-395-3837",
            "fax_number": "803-536-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 215",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-395-3837",
            "fax_number": "803-536-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKALOO",
        "first_name": "JERROLD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "SC",
            "license": "20903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID-RSFPN",
            "identifier": "P00727280",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209036",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "P00401081",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Brunson, MD
• James H Brunson Jr., MD
• Ashley Meador Bryan, PA
• Randolph Charles Bryson, D.M.D.
• Zachary Michael Buchanan, DO
• Carey Alan Bunch, CPO
• Jennifer S Bunch, OTR/L
• L Jarrette Burckhalter IV, DMD
• Bridgett Shavonne Burnett, LPN
• Maia Burnett, RD, LD

• Orthopaedic Hand Surgery Physician in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Orthopaedic Hand Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.