Paul Edward Buckthal, MD
Individual provider Active NPI Neurology Physician · Sayre, PA
NPI 1609840271 · NPPES record last updated Jun 22, 2011
Key facts
- NPI
- 1609840271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- MD014657E (PA)
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- State University of Ny Upstate Medical University, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Guthrie Medical Group PC
Practice addresses (Care Compare)
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Hospital & facility affiliations
- Robert Packer Hospital
- Our Lady of Lourdes Memorial Hospital, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110113000993 | PA | Practitioner - Neurology | 8820287378 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152834-1 | NY | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Neurology | Current |
Accepting new patients |
| Guthrie Medical Group, P.C. | Neurology | Current |
Accepting new patients |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients | |
| Guthrie Clinic LTD | Past | Accepting new patients |
Locations
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- pbuckthal8228@direct-guthrie.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD014657E | PA | Yes |
| Neurology Physician | 2084N0400X | 152834-1 | NY |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00365095 | Medicaid | NY | |
| 130022275 | Other | PA | RR MEDICARE PIN |
| 0006857800001 | Medicaid | PA | |
| CC9269 | Other | PA | RR MEDICARE GROUP |
| GU039821 | Other | PA | MEDICARE GROUP |
Other providers in Sayre, PA
- Mark C Bristol
- Avril E. Brown
- Daniel Joseph Brown
- Madelen Brunner
- Abraham Karl Buckley
- Klariza R Buda
- Rasmita Budhathoki
- Anna Bui
- Jessica Bulkley
- Shawn Trevor Bunnell
All providers in Sayre, PA · Neurology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.