Kelly M Buckley, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN270478 Issued in MA

Practice address

22 Atwood Dr
Northampton, MA 01060-4267

Phone

(413) 584-4547

NPI assigned

Nov 19, 2018

Sex

Female

Sole proprietor

Yes

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.

• Mass General Brigham Medical Group Western Massachusetts Inc

  • Psychiatry Physician
  • Northampton, MA
  • NPI 1942605373

  MA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Center for Human Development, Inc.

  • Community/Behavioral Health Agency
  • Springfield, MA
  • NPI 1912099219

  MA, Single Specialty

  Medicare reassignment NPD
• Community Health Programs, Inc.

  • Federally Qualified Health Center (FQHC)
  • Great Barrington, MA
  • NPI 1013953009

  MA, Single Specialty

  Medicare reassignment NPD
• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919

  Single Specialty

  Care Compare group NPD
• Presence & Peace Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Northampton, MA
  • NPI 1225996416

  Single Specialty

  NPD Authorized official
• Center for Human Development, Inc

  • Family Medicine Physician
  • West Springfield, MA
  • NPI 1861250953

  Single Specialty

  NPD
• Community Health Programs, Inc.

  • Pediatrics Physician
  • Pittsfield, MA
  • NPI 1942720214

  Single Specialty

  NPD

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mass General Brigham Medical Group Western Massachusetts Inc 291 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 10, 2023.

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1669941738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COPLEY TER",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ATWOOD DR",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604267",
            "telephone_number": "413-584-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN270478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Peter Brunswick, M.D.
• Jennifer Bryan, PH.D.
• Rebecca Bryer
• Tristyn Buck, RN
• Charley William Buckley
• Brooke Bull, LMFT
• Carole Bull, M.ED., LSW, LMHC
• Joni Skinner Bullough, AU.D.
• Caitlin Bunning, LCSW
• Deborah J Burkhalter, LICSW

• All providers in Northampton, MA
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.
• 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.