GARY TYLER BUCKHOLZ MD
NPI 1174601702
Family Medicine - Hospice and Palliative Medicine in San Diego, CA

Q: What is Gary Buckholz's NPI number?

The NPI number for Gary Buckholz is 1174601702. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Gary Buckholz's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Q: When was this NPI record last updated?

The NPPES record for Gary Buckholz was last updated on August 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 01, 2006PECOS Enrolled

4311 THIRD AVE, SAN DIEGO, CA 92103(619) 688-1600(619) 278-6163 Get Directions Write a Review

NPPES record last updated: August 16, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Gary Tyler Buckholz Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY TYLER BUCKHOLZ MD (NPI 1174601702) is an individual hospice and palliative medicine provider in San Diego, California, licensed in California (A82836) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174601702

Entity TypeIndividualMale

Primary Taxonomy207QH0002X

Provider Legal NameGARY TYLER BUCKHOLZCredential: MD

Location Address4311 THIRD AVESan Diego, CA 92103-1407

Mailing AddressPo Box 232410San Diego, CA 92193-2410 · (858) 249-6749

Phone(619) 688-1600

Fax(619) 278-6163

Sole ProprietorNo

Enumeration DateNovember 1, 2006

Last NPPES UpdateAugust 16, 2017

✔ NPI 1174601702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QH0002X

License✔ Licensed in CA · A82836

Definition

A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.

Also ListedFamily MedicineTaxonomy 207Q00000X · License A82836 (CA)

4311 THIRD AVE, San Diego, CA 92103

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Other Identifiers 2

Medicare ID-Type UnspecifiedW11822CA

Medicare UPINI51642CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Tyler Buckholz Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT A IRWIN MD

Psychiatry & Neurology (Psychiatry)

4311 THIRD AVE
SAN DIEGO, CA 92103

San Diego County (619) 688-1600

JULIE A PRAZICH MD

General Practice

4311 THIRD AVE
SAN DIEGO, CA 92103

San Diego County (619) 688-1600

CHARLES R LEWIS MD

Family Medicine

4311 THIRD AVE
SAN DIEGO, CA 92103

San Diego County (619) 688-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Buckholz's NPI number?

The NPI number for Gary Buckholz is 1174601702. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Gary Buckholz located?

Gary Buckholz practices at 4311 Third Ave, San Diego, CA 92103. The listed phone number is (619) 688-1600.

What is Gary Buckholz's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Is Gary Buckholz enrolled in Medicare?

Yes. Gary Buckholz is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Buckholz was last updated on August 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.