Individual provider Active NPI

Maureen Dee Buckley, NP

  • Adult Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1619377447
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95001205 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(802) 233-6137
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95001205 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

1755 Friedrick Dr
San Diego, CA 92104-5751
Phone (802) 233-6137

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141222000682 CA Practitioner - Nurse Practitioner 6002139193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1910
Phone (858) 657-7000

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9400 Campus Point Dr
La Jolla, CA 92093-1350
Phone (858) 657-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
731671CAMDLicensed Vocational Nurse
95001205CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 27, 2014 Accepting new patients
Regents of the University of California CurrentSince Sep 27, 2014 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1200 Garden View Rd
Encinitas, CA 92024
Phone (760) 536-7682

1200 Garden View Rd
Ste 100
Encinitas, CA 92024
Phone (760) 436-6188

9350 Campus Point Dr
Ste 1B
La Jolla, CA 92037
Phone (858) 657-8200

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4520 Executive Dr
Ste 1
San Diego, CA 92121

4520 Executive Dr
San Diego, CA 92121
Phone (858) 249-1429

Organizations & group practices 4

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 1

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1619377447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 FRIEDRICK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045751",
            "telephone_number": "802-233-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "802-233-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MAUREEN",
        "middle_name": "DEE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95001205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.