TIMOTHY J BUCKLAEW (NPI# 1407310741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407310741 |
| Entity Type | Individual |
| Full Name | TIMOTHY J BUCKLAEW |
| Credential | PA |
| Practice Address |
229 Parrish St Ste 100 Canandaigua NY 14424-1791 |
| Mailing Address |
57 Baier Dr Rochester NY 14606-5311 |
| Practice Telephone | 5853941960 |
| Practice Fax Number | 5853939232 |
| Mailing Telephone | 5857553908 |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2020-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
229 PARRISH ST STE 100 |
| City | CANANDAIGUA |
| State | NY |
| Zip Code | 14424-1791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568431732 | Kurt Lucas | Physician Assistant | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2006-03-17 |
| 1881202158 | Katrina Bruzda | Physician Assistant | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2020-07-22 |
| 1104319300 | Michael Jenkins | Physician Assistant | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2018-06-12 |
| 1831110360 | Kevin R Hopson | Podiatrist | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2006-07-21 |
| 1962420554 | Richard Edward Lee II | Nurse Practitioner | 229 Parrish St Ste 100, Canandaigua, NY 14424 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725029 | Stefanie Ann Hook | Nurse Practitioner | 395 West Street, Suite 101, Canandaigua, NY 14424 | 2019-11-21 |
| 1285120618 | Mary Kathleen Woodruff | Counselor | 163 Gibson Street, Canandaigua, NY 14424 | 2018-07-09 |
| 1699260612 | Victoria Record | Nurse Practitioner | 3325 Marvin Sands Dr, Canandaigua, NY 14424 | 2018-06-22 |
| 1649767443 | Liana Irene Schenk | Counselor | 5297 Parkside Drive, Building 400, Suite 408, Canandaigua, NY 14424 | 2018-04-17 |
| 1225534019 | Brook Slaby | Counselor | 5297 Parkside Dr Building 400 Office 411, Canandaigua, NY 14424 | 2018-04-02 |
| 1154839710 | Madasyn Leigh Smith | Physical Therapist | 229 Parrish St Ste 220, Canandaigua, NY 14424 | 2018-01-17 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1235674599 | Wendy Williams | Early Intervention Provider Agency | 5145 North Bloomfiled Road, Canandaigua, NY 14424 | 2016-12-22 |
| 1326418252 | Mary Christine Casella | Registered Nurse | 90 West Gibson Street, Canandaigua, NY 14424 | 2015-10-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| Find all providers in zip 14424 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508073677 | Timothy Alan Jensen | Physician Assistant | 5149 Sage Ter, Canandaigua, NY 14424-8243 | 2007-05-17 |
| 1942243522 | Edward Martin Kenney | Physician Assistant | 97 Granger St, Canandaigua, NY 14424-1110 | 2006-06-13 |
| 1841231529 | John Philip Thompson | Physician Assistant | 114 Hubbell St, Canandaigua, NY 14424-1350 | 2006-06-10 |
| 1790722114 | Jeffrey Saunders Trumbull | Physician Assistant | 185 Gibson St, Suite 100, Canandaigua, NY 14424-1340 | 2006-06-02 |
| 1568431732 | Kurt Lucas | Physician Assistant | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2006-03-17 |
| 1548868193 | Cassandra Schwach | Physician Assistant | 395 West Street, Suite 001, Canandaigua, NY 14424-1789 | 2020-10-15 |
| 1871135327 | Jayson Villeneuve | Physician Assistant | 350 Parrish St, Canandaigua, NY 14424-1731 | 2019-10-16 |
| 1073089371 | Morgan Devuyst | Physician Assistant | 350 Parrish St, Canandaigua, NY 14424-1793 | 2018-10-15 |
| 1225504442 | Deanna Helene Petersen | Physician Assistant | 350 Parrish St, Canandaigua, NY 14424-1731 | 2018-10-15 |
| 1104319300 | Michael Jenkins | Physician Assistant | 229 Parrish St Ste 100, Canandaigua, NY 14424-1791 | 2018-06-12 |
| Find all providers in CANANDAIGUA | ||||
| City | CANANDAIGUA |
| Zip Code | 14424 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.