NPIMap

Individual provider Active NPI

Jeremy Buckley, M.D.

  • Cardiovascular Disease Physician
  • Lancaster, OH
National Provider Identifier
1720106248
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35093475 Issued in OH
Practice address
2405 N Columbus St
Suite 100
Lancaster, OH 43130-8185
Phone
(740) 689-4480
Fax
(740) 277-7692
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35093475 OH Primary
Interventional Cardiology Physician 207RI0011X 35093475 OH
Internal Medicine Physician 207R00000X 35093475 OH

Addresses

Primary practice location

2405 N Columbus St
Suite 100
Lancaster, OH 43130-8185

Mailing address

1153 E Main St
PO Box 2563
Lancaster, OH 43130-4056
Phone (740) 687-8990

Other identifiers 1

IdentifierTypeStateIssuer
2954905MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090812000000 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 1355413659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Ohio State University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

819 State Route 664 N
Side a
Logan, OH 43138-8540
Phone (740) 689-4430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as group
Quality
43.39
Promoting interoperability
100
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35093475OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals, Inc. CurrentSince Feb 15, 2013 Accepting new patients
Fairfield Healthcare Professionals Inc CurrentSince Feb 15, 2013 Accepting new patients
Columbus Radiology Corp Past Accepting new patients
Geisinger Clinic Past Accepting new patients
Fairfield Healthcare Professionals, Inc. Past Accepting new patients
Fairfield Medical Center Past Accepting new patients

Locations

5115 Amanda Northern Rd SW
Amanda, OH 43102
Phone (740) 969-4121

2405 N Columbus St
Ste 100
Lancaster, OH 43130
Phone (614) 908-1339

1153 E Main St
Lancaster, OH 43130
Phone (740) 687-8990

131 N Ewing St
Ste C
Lancaster, OH 43130
Phone (740) 689-6600

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

2405 N Columbus St
Ste 200
Lancaster, OH 43130
Phone (740) 689-3627

819 State Route 664 N
Side A
Logan, OH 43138
Phone (740) 689-4430

601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000

Interoperability endpoints

  • Direct secure messaging: jbuckley553199@direct.osumc.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1720106248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 E MAIN ST",
            "address_2": "PO BOX 2563",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304056",
            "telephone_number": "740-687-8990",
            "fax_number": "740-687-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST",
            "address_2": "SUITE 100",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308185",
            "telephone_number": "740-689-4480",
            "fax_number": "740-277-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JEREMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35093475",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35093475",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35093475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2954905",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.