Charles Edward Buckley, MD is a medicare enrolled "Radiology - Nuclear Radiology" physician in College Park, Maryland. His current practice location is
4700 Berwyn House Rd, Suite 102, College Park, Maryland. You can reach out to his office (for appointments etc.) via phone at
(301) 345-0406.
Charles Edward Buckley is licensed to practice in Maryland (license number D16341) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134128051.
Physician's Profile
Full Name | Charles Edward Buckley |
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Gender | Male |
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Speciality | Radiology - Nuclear Radiology |
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Location | 4700 Berwyn House Rd, College Park, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1134128051
- Provider Enumeration Date: 07/21/2005
- Last Update Date: 03/14/2008
Medicare PECOS Information:
- PECOS PAC ID: 1759446289
- Enrollment ID: I20090218000074
Medical Identifiers
Medical identifiers for Charles Edward Buckley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134128051 | NPI | - | NPPES |
0430630 | Medicaid | DC | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085N0904X | Radiology - Nuclear Radiology | D16341 (Maryland) | Primary |
2085N0904X | Radiology - Nuclear Radiology | MD25540 (District Of Columbia) | Secondary |
2085N0904X | Radiology - Nuclear Radiology | 019671 (Virginia) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Edward Buckley allows following entities to bill medicare on his behalf.
Entity Name | Symphony Diagnostic Services No 1 Llc |
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Entity Type | Part B Supplier - Portable X-ray Supplier |
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Entity Identifiers | NPI Number: 1700865094 PECOS PAC ID: 5193638765 Enrollment ID: O20031121000061 |
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Entity Name | Sheppard Pratt Physicians Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1518990712 PECOS PAC ID: 8224937610 Enrollment ID: O20040105000737 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Edward Buckley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Charles Edward Buckley, MD 4700 Berwyn House Rd, Suite 207, College Park, MD 20740-2474 Ph: (301) 220-0150 | Charles Edward Buckley, MD 4700 Berwyn House Rd, Suite 102, College Park, MD 20740-2474 Ph: (301) 345-0406 |
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