Nicole Fabico Vales-Buckwald, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NN08808600 Issued in NJ

Practice address

5301 Broadway
West New York, NJ 07093-2622

Phone

(201) 866-9320

Fax

(201) 866-7588

NPI assigned

Apr 3, 2008

Last updated

Feb 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Vales Buckwald Other name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

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

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  dba Advocare Berlin Medical Associates (DME)

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  dba Advocare Merchantville Pediatrics

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1801069521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MATTBEN DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070597142",
            "telephone_number": "908-420-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BROADWAY",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932622",
            "telephone_number": "201-866-9320",
            "fax_number": "201-866-7588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 James St Ste 1G",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606348",
            "country_code": "US",
            "telephone_number": "973-540-9393",
            "fax_number": "973-540-1937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALES-BUCKWALD",
        "first_name": "NICOLE",
        "middle_name": "FABICO",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-03",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN08808600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ APRN LICENSE",
            "identifier": "26NN08808600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BUCKWALD",
            "middle_name": "VALES",
            "credential": "CPNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in West New York, NJ
• Providers in West New York, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.