Jackson Thomas Lee Buckman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002704 Issued in AZ

Practice address

2277 Swanson Ave Ste 100
Lake Havasu City, AZ 86403-6141

Phone

(928) 706-9991

NPI assigned

Jun 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Havasu Family Eyecare LLCGroup PAC ID 0749220051, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.83 of 100Reported as group

Quality

65.65

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lake Havasu Family Eyecare, LLC

  • Optometrist
  • Lake Havasu City, AZ
  • NPI 1457569121
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1699451823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 SWANSON AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036141",
            "telephone_number": "928-706-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 SWANSON AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036141",
            "telephone_number": "928-706-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMAN",
        "first_name": "JACKSON",
        "middle_name": "THOMAS LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brighter Beginnings Therapy
• Stephanie R Brison, APRN
• Sandra Marie Bronni, M.D.
• Brookeside LLC
• Pamela Robin Brookman
• Buena Suerte, Inc.
• Ryan Newell Bullen, DMD, DHSC
• Rhett Melvin Burgener, OD
• Derek M Burnett, MD
• Lynn Marie Burns, RN

• Optometrist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.