Individual provider Active NPI

Jacob Kenneth Buccini, AU.D.

  • Audiologist
  • Fort Bliss, TX
National Provider Identifier
1821627795
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
14227 Issued in NC
Practice address
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Phone
(915) 742-7777
NPI assigned
Apr 3, 2020
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 14227 NC Primary

Addresses

Primary practice location

18511 Highlander Medics St
Fort Bliss, TX 79906-5327

Mailing address

1480 Town Creek Rd
Eden, NC 27288-8054
Phone (336) 280-5258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807000072 NC Practitioner - Qualified Audiologist 6002231040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

115 Kildaire Park Dr
Suite 308
Cary, NC 27518-8144
Phone (984) 974-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14227NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Current Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Jun 1, 2020 Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Nov 8, 2023 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Audiologist CurrentSince Nov 8, 2023 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
Moses Cone Physician Services Inc CurrentSince Jun 1, 2020 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

115 Kildaire Park Dr
Ste 308
Cary, NC 27518
Phone (919) 784-7460

100 Sprunt St
Chapel Hill, NC 27517
Phone (919) 843-2164

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2226 Nelson Hwy
Ste 102
Chapel Hill, NC 27517
Phone (984) 974-2113

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

3824 N Elm St
Ste 201
Greensboro, NC 27455
Phone (336) 542-2015

5221 Paramount Pkwy
Ste 440
Morrisville, NC 27560
Phone (984) 974-1183

621 S Main St
Ste 205
Reidsville, NC 27320
Phone (336) 342-6880

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1821627795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 TOWN CREEK RD",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272888054",
            "telephone_number": "336-280-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCINI",
        "first_name": "JACOB",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "14227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bliss, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.