Individual provider Active NPI

Nicholas Salpeter Buckley, DO

  • Geriatric Medicine (Family Medicine) Physician
  • San Mateo, CA
National Provider Identifier
1942738679
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
20A18014 Issued in CA
Practice address
66 Bovet Rd Ste 100
San Mateo, CA 94402-3126
Phone
(650) 554-1000
Fax
(650) 554-1018
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 20A18014 CA Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 20A18014 CA

Addresses

Primary practice location

66 Bovet Rd Ste 100
San Mateo, CA 94402-3126

Mailing address

1900 S Norfolk St Ste 350
San Mateo, CA 94403-1171
Phone (650) 532-2321

Other practice location 1

1609 Trousdale Dr
Burlingame, CA 94010-4520
Phone (650) 652-3969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200609003071 CA Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 3971924465 Reassigns benefits to 4 organizations
Practice locations: Burlingame, CA; San Mateo, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18014CAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Jun 24, 2020 Accepting new patients
Mission Hospice & Home Care Inc. CurrentSince May 24, 2024 Accepting new patients
American Specialty Physicians Group Inc CurrentSince Mar 27, 2024 Accepting new patients
Pacific Inpatient Medical Group Current Accepting new patients
Niagara Falls Memorial Medical Center PastSince Aug 1, 2019 Accepting new patients

Locations

151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308

1125 Sir Francis Drk Blvd
Kentfield, CA 94904
Phone (415) 456-9680

700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851

450 Stanyan St
Fl 6
San Francisco, CA 94117
Phone (415) 456-9680

1670 S Amphlett Blvd
Ste 300
San Mateo, CA 94402
Phone (650) 554-1000

66 Bovet Rd
Ste 100
San Mateo, CA 94402
Phone (650) 554-1000

324 Wilmington Ave
Kettering, OH 45420
Phone (937) 256-4490

Interoperability endpoints

  • Direct secure messaging: nbuckley335348@direct-ucsfmedicalcenter.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/
  • Direct secure messaging: nbuckley361857@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1942738679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S NORFOLK ST STE 350",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031171",
            "telephone_number": "650-532-2321",
            "fax_number": "650-532-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BOVET RD STE 100",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023126",
            "telephone_number": "650-554-1000",
            "fax_number": "650-554-1018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1609 Trousdale Dr",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "940104520",
            "country_code": "US",
            "telephone_number": "650-652-3969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "NICHOLAS",
        "middle_name": "SALPETER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "20A18014",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "20A18014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.