NPIMap

Organization Active NPI

Buncke Medical Clinic Inc.

  • Plastic and Reconstructive Surgery Physician
  • San Francisco, CA
National Provider Identifier
1750371571
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
35001 Issued in CA
Legal business name
BUNCKE MEDICAL CLINIC INC.
Practice address
45 Castro St.
#121
San Francisco, CA 94114-1010
Phone
(415) 565-6136
Fax
(415) 864-1654
NPI assigned
Oct 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Authorized official

Name
Dr. Gregory M. BunckeNPI 1396736633
Title
Owner
Phone
(415) 565-6136

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
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0122X 35001 CA Primary

Addresses

Primary practice location

45 Castro St.
#121
San Francisco, CA 94114-1010

Mailing address

45 Castro St.
#121
San Francisco, CA 94114-1010
Phone (415) 565-6136

Other identifiers 1

IdentifierTypeStateIssuer
GR0046560MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000543 CA Part B Supplier - Clinic/Group Practice 4183524408 Receives reassigned benefits from 8 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory
Tax ID family
Buncke Medical Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: gregorybuncke@bmci.allscriptsdirect.net

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": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1750371571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CASTRO ST.",
            "address_2": "#121",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141010",
            "telephone_number": "415-565-6136",
            "fax_number": "415-864-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CASTRO ST.",
            "address_2": "#121",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141010",
            "telephone_number": "415-565-6136",
            "fax_number": "415-864-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUNCKE MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "BUNCKE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-565-6136",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "35001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.