NPIMap

Organization Active NPI

Buckley Road Pediatrics, PLLC

  • Pediatrics Physician
  • North Syracuse, NY
National Provider Identifier
1669535548
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
264506 Issued in NY
Legal business name
BUCKLEY ROAD PEDIATRICS, PLLC
Practice address
7270 Buckley Rd
North Syracuse, NY 13212-2649
Phone
(315) 458-0521
Fax
(315) 458-7940
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Authorized official

Name
Dr. Jennifer C Sacks, MDNPI 1548404932
Title
Owner
Phone
(315) 458-0521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 264506 NY Primary

Addresses

Primary practice location

7270 Buckley Rd
North Syracuse, NY 13212-2649

Mailing address

7270 Buckley Rd
North Syracuse, NY 13212-2649
Phone (315) 458-0521

National Provider Directory

National Provider Directory

Locations

7270 Buckley Rd
North Syracuse, NY 13212
Phone (315) 452-0485

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1669535548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7270 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122649",
            "telephone_number": "315-458-0521",
            "fax_number": "315-458-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7270 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122649",
            "telephone_number": "315-458-0521",
            "fax_number": "315-458-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKLEY ROAD PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-458-0521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "264506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.