DR. LISA M BUCKLOH PHD
NPI 1811003734
Psychologist - Clinical Child & Adolescent in Jacksonville, FL

Q: What is Lisa Buckloh's NPI number?

The NPI number for Lisa Buckloh is 1811003734. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Q: What is Lisa Buckloh's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Buckloh was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 August 22, 2006PECOS Enrolled

807 CHILDRENS WAY, JACKSONVILLE, FL 32207(904) 390-3600(904) 390-3512 Get Directions Write a Review

NPPES record last updated: September 7, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Lisa M Buckloh Phd NPPES

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

DR. LISA M BUCKLOH PHD (NPI 1811003734) is an individual clinical child & adolescent provider in Jacksonville, Florida, licensed in Florida (PY6027) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811003734

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. LISA M BUCKLOHCredential: PHD

Location Address807 CHILDRENS WAYJacksonville, FL 32207-8426

Mailing AddressPo Box 191, Provider Enrollment DeptRockland, DE 19732-0191 · (302) 651-6212 · Fax (302) 651-4945

Phone(904) 390-3600

Fax(904) 390-3512

Sole ProprietorNo

Enumeration DateAugust 22, 2006

Last NPPES UpdateSeptember 7, 2011

✔ NPI 1811003734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in FL · PY6027

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

807 CHILDRENS WAY, Jacksonville, FL 32207

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Other Identifiers 1

Medicaid000846942AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa M Buckloh Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Buckloh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Nemours Foundation

Same address

Multi-Specialty

807 CHILDRENS WAY
Jacksonville, FL 32207

Reassigned Medicare billing, Florida enrollment
703 clinicians in this Medicare group

NPI 1265585806 (904) 697-3600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

DR. KENNETH FRANZ-JOSEPH HEARN MD

Pediatrics

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (904) 697-3600

MR. HUGH E. GRIFFENKRANZ PA-C

Physician Assistant

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (904) 390-3737

JACQUELINE M NOE

Physician Assistant

807 CHILDRENS WAY, NEMOURS CHILDRENS CLINIC, JACKSONVILLE
JACKSONVILLE, FL 32207

Duval County (904) 697-3600

ERIC P. SHERLIN R.PH

Pharmacist

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (904) 390-3601

KELLY MARIE SUMMERS ARNP

Nurse Practitioner

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (904) 697-3600

ROBERT C SPRECHER MD

Otolaryngology (Pediatric Otolaryngology)

807 CHILDRENS WAY, NEMOURS CHILDRENS CLINIC, JACKSONVILLE
JACKSONVILLE, FL 32207

Duval County (904) 697-3694

DR. DOREEN RADJENOVIC ARNP

Nurse Practitioner

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (904) 390-3759

GRACE ELIZABETH ALLEMAN SLP

Speech-Language Pathologist

807 CHILDRENS WAY
JACKSONVILLE, FL 32207

Duval County (907) 697-3600

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 Lisa Buckloh's NPI number?

The NPI number for Lisa Buckloh is 1811003734. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Lisa Buckloh located?

Lisa Buckloh practices at 807 Childrens Way, Jacksonville, FL 32207. The listed phone number is (904) 390-3600.

What is Lisa Buckloh's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Lisa Buckloh enrolled in Medicare?

Yes. Lisa Buckloh is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Buckloh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Buckloh reassigns Medicare benefits to The Nemours Foundation (Jacksonville, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Buckloh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Buckloh accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Lisa Buckloh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Buckloh was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.