Keith D Buckley, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in Mobile, Alabama. His current practice location is
5 Mobile Infirmary Cir, Mobile, Alabama. You can reach out to his office (for appointments etc.) via phone at
(251) 432-4497.
Keith D Buckley is licensed to practice in Alabama (license number 1088997) 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 1972651859.
Physician's Profile
| Full Name | Keith D Buckley |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 5 Mobile Infirmary Cir, Mobile, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1972651859
- Provider Enumeration Date: 01/08/2007
- Last Update Date: 02/11/2008
Medicare PECOS Information:
- PECOS PAC ID: 3779687280
- Enrollment ID: I20070322000278
Medical Identifiers
Medical identifiers for Keith D Buckley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972651859 | NPI | - | NPPES |
| 051539202 | Other | AL | BC OF AL |
| 009941427 | Medicaid | AL | |
| 009941428 | Medicaid | AL | |
| 009941431 | Medicaid | AL | |
| 051539203 | Other | AL | BC OF AL |
| 051539204 | Other | AL | BC OF AL |
| 009941429 | Medicaid | AL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 1-088997 (Alabama) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 1088997 (Alabama) | Primary |
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. Keith D Buckley allows following entities to bill medicare on his behalf.
| Entity Name | Anesthesiologists Associated Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851371850
PECOS PAC ID: 6204739519
Enrollment ID: O20040202000465 |
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| Entity Name | Anesthesia Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649265810
PECOS PAC ID: 1557352754
Enrollment ID: O20040518001018 |
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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. Keith D 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 |
|---|
Keith D Buckley, CRNA
Po Box 934369,
Atlanta, GA 31193-0001
Ph: (800) 897-6169 | Keith D Buckley, CRNA
5 Mobile Infirmary Cir,
Mobile, AL 36607-3513
Ph: (251) 432-4497 |
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