NPIMap

Individual provider Active NPI

William James Buckley, MD

  • Cardiovascular Disease Physician
  • Riverhead, NY
National Provider Identifier
1710155916
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
233724 Issued in NY
Practice address
1279 E Main St
Riverhead, NY 11901-2583
Phone
(631) 727-2100
Fax
(631) 727-2646
NPI assigned
Feb 11, 2008
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 233724 NY Primary

Addresses

Primary practice location

1279 E Main St
Riverhead, NY 11901-2583

Mailing address

1279 E Main St
Riverhead, NY 11901-2583
Phone (631) 727-2100

Other identifiers 1

IdentifierTypeStateIssuer
02975244MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wbuckley238807@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080701000039 NY Practitioner - Cardiovascular Disease (Cardiology) 3577635911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

11700 Main Rd
Suite 7
Mattituck, NY 11952-1525
Phone (631) 963-4770

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-2701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
233724NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Cardiovascular Disease CurrentSince Oct 1, 2018 Accepting new patients
New York University Cardiovascular Disease CurrentSince Oct 1, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients
Winthrop Community Medical Affiliates PC Cardiovascular Disease Past Accepting new patients

Locations

6835 Myrtle Ave
Glendale, NY 11385
Phone (718) 386-9876

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1279 E Main St
Riverhead, NY 11901
Phone (631) 727-2100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: wbuckley238807@nyumc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1710155916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012583",
            "telephone_number": "631-727-2100",
            "fax_number": "631-727-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012583",
            "telephone_number": "631-727-2100",
            "fax_number": "631-727-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "233724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02975244",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wbuckley238807@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1279 E Main St",
            "city": "Riverhead",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119012583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.