Individual provider Active NPI

Joseph Michael Buckley, D.C.

  • Chiropractor
  • Pembroke Pines, FL
National Provider Identifier
1669533626
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6662 Issued in FL
Practice address
18501 Pines Blvd Ste 104
Pembroke Pines, FL 33029-1414
Phone
(954) 432-3343
Fax
(954) 450-2565
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6662 FL Primary

Addresses

Primary practice location

18501 Pines Blvd Ste 104
Pembroke Pines, FL 33029-1414

Mailing address

18501 Pines Blvd Ste 104
Pembroke Pines, FL 33029-1414
Phone (954) 432-3343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000241 FL Practitioner - Chiropractic 8628036894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18501 Pines Blvd
Pembroke Pines, FL 33029-1414
Phone (954) 432-3343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH6662FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pines West Chiropractic Inc Chiropractor CurrentSince Oct 1, 1996 Accepting new patients

Locations

18501 Pines Blvd
Ste 103
Pembroke Pines, FL 33029

18501 Pines Blvd
Ste 104
Pembroke Pines, FL 33029
Phone (954) 432-3343

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1669533626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18501 PINES BLVD STE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291414",
            "telephone_number": "954-432-3343",
            "fax_number": "954-450-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 PINES BLVD STE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291414",
            "telephone_number": "954-432-3343",
            "fax_number": "954-450-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.