Individual provider Active NPI

Mikhel Charles Buck, LCSW

  • Psychologist
  • North Miami, FL
National Provider Identifier
1790803922
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SW0002763 Issued in FL
Practice address
1800 Northeast 114 Street
801
North Miami, FL 33181-3417
Phone
(305) 891-1067
Fax
(305) 891-1067
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X SW0002763 FL Primary

Addresses

Primary practice location

1800 Northeast 114 Street
801
North Miami, FL 33181-3417

Mailing address

1800 Northeast 114 Street
801
North Miami, FL 33181-3417
Phone (305) 891-1067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215000448 FL Practitioner - Clinical Social Worker 7810954492 Practice locations: North Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1800 NE 114TH St
Suite 801
North Miami, FL 33181-3417
Phone (305) 891-1067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW0002763FLMDPsychologist

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": "1183852800000",
    "number": "1790803922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NORTHEAST 114 STREET",
            "address_2": "801",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813417",
            "telephone_number": "305-891-1067",
            "fax_number": "305-891-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NORTHEAST 114 STREET",
            "address_2": "801",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813417",
            "telephone_number": "305-891-1067",
            "fax_number": "305-891-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MIKHEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "SW0002763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.