Individual provider Active NPI

Robert Scott Buckingham, OD

  • Optometrist
  • Big Rapids, MI
National Provider Identifier
1851312573
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002795 Issued in MI
Practice address
1310 Cramer Circle
Pennock 506
Big Rapids, MI 49307-2738
Phone
(231) 591-2222
Fax
(231) 591-3991
NPI assigned
Jul 21, 2006
Last updated
Jan 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002795 MI Primary

Addresses

Primary practice location

1310 Cramer Circle
Pennock 506
Big Rapids, MI 49307-2738

Mailing address

1310 Cramer Circle
Pennock 506
Big Rapids, MI 49307-2738
Phone (231) 591-2222

Other identifiers 1

IdentifierTypeStateIssuer
RB002795OtherMIBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100527000129 MI Practitioner - Optometry 4789653932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ferris State UniversityGroup PAC ID 3971572124, 27 clinicians

Practice addresses (Care Compare)

1124 S State St
University Eye Center
Big Rapids, MI 49307-2256
Phone (231) 591-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901002795MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ferris State University CurrentSince Oct 2, 2018 Accepting new patients
Ferris State University Optometrist CurrentSince Oct 2, 2018 Accepting new patients

Organizations & group practices 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1851312573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CRAMER CIRCLE",
            "address_2": "PENNOCK 506",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072738",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CRAMER CIRCLE",
            "address_2": "PENNOCK 506",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072738",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "RB002795",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.