Individual provider Active NPI

Theresa A Buckson, M.D.

  • Obstetrics & Gynecology Physician
  • South Miami, FL
National Provider Identifier
1881671626
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME140849 Issued in FL
Practice address
6200 SW 73Rd St
South Miami, FL 33143-4679
Phone
(786) 662-4000
NPI assigned
Dec 22, 2005
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0056988 MD
Obstetrics & Gynecology Physician 207V00000X ME140849 FL Primary

Addresses

Primary practice location

6200 SW 73Rd St
South Miami, FL 33143-4679

Mailing address

777 Lowndes Hill Rd BLDG 1
Greenville, SC 29607-2101
Phone (864) 908-3530

Other identifiers 1

IdentifierTypeStateIssuer
693501000MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL email Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060125000271 MD Practitioner - Obstetrics/Gynecology 9830118181 Reassigns benefits to 2 organizations
I20191023003405 FL Practitioner - Obstetrics/Gynecology 9830118181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Virginia Commonwealth University, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

6200 SW 73 St
South Miami, FL 33143-4679
Phone (800) 967-2289

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME140849FLMDObstetrics & Gynecology Physician
D0056988MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Feb 1, 2006 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Sep 26, 2019 Accepting new patients
Aditya Chopra, MD, PC CurrentSince Apr 8, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Feb 1, 2006 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Sep 26, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Allara Medical Group PA Obstetrics & Gynecology Past Accepting new patients
Maryland General Professional Practices Inc. Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

2002 Medical Pkwy
Ste 635
Annapolis, MD 21401
Phone (410) 224-1133

2003 Medical Pkwy
Ste 300
Annapolis, MD 21401
Phone (410) 266-6035

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

600 Ridgely Ave
Ste 231
Annapolis, MD 21401
Phone (410) 266-8116

4175 N Hanson Ct
Ste 209
Bowie, MD 20716
Phone (301) 352-4007

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 603-5203

Interoperability endpoints

  • Direct secure messaging: theresa.buckson@335000925634564.direct.elationemr.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1881671626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 LOWNDES HILL RD BLDG 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072101",
            "telephone_number": "864-908-3530",
            "fax_number": "864-627-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "786-662-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKSON",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0056988",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME140849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693501000",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6200 SW 73rd St",
            "city": "South Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331434679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.