Amy Lou Buchanan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004421 Issued in MI

Practice address

6749 Cascade Rd SE
Grand Rapids, MI 49546-6849

Phone

(616) 957-3099

Fax

(616) 957-3729

NPI assigned

May 31, 2007

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

• Amy Lou Fitzgibbon Former name

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott M. Buckingham, OD PCGroup PAC ID 3476630112, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Scott M. Buckingham, OD PC

  • Optometrist
  • Midland, MI
  • NPI 1790966646
  Medicare reassignment Care Compare group NPD
• Buckingham and Kaminski PLC

  • Optometrist
  • Midland, MI
  • NPI 1205047305
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1922209451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 S PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012762",
            "telephone_number": "269-342-0003",
            "fax_number": "269-342-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6749 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466849",
            "telephone_number": "616-957-3099",
            "fax_number": "616-957-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "AMY",
        "middle_name": "LOU",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922209451",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FITZGIBBON",
            "middle_name": "LOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda R Brygal, LLMSW
• Raven Bryson
• Carrie Ann Brzezinski, PT
• Kshiti Buch, MD
• Christopher Michael Buchach, M.D.
• Brian Buchanan, DPM
• Jan Margaret Buchanan, CNM
• Lane Katherine Buchanan
• Kasey Bucher, PHARMD
• Ian E Buchheister, BSW

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.
• 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.