REBECCA BUCKNER (PHYSICIAN ASSISTANT) – Surgical Physician Assistant, NPI 1013809748

REBECCA BUCKNER (PHYSICIAN ASSISTANT) is a healthcare provider. based in Fort worth, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. PA19354 (TX). The NPI Number for REBECCA BUCKNER (PHYSICIAN ASSISTANT) is 1013809748

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
REBECCA BUCKNER (PHYSICIAN ASSISTANT)
NPI
1013809748
Phone
(817) 946-8385
Address
12825 VILLA MILANO DR
Enumeration Date
17 July 2025
Last Update Date
29 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2813324596
Graduation Year
2025 (1 year ago)
PAC ID
2264933803
Group Practice PAC ID
6103904461
Professional Enrollment ID
I20250827001330
Address ID
TX775984233WE450XXBLVD501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for REBECCA BUCKNER (PHYSICIAN ASSISTANT)

  • 12825 VILLA MILANO DR

    FORT WORTH, TX 761266114

    Phone: (817) 946-8385

    Type: Mailing

  • 450 W MEDICAL CENTER BLVD STE 600

    WEBSTER, TX 775984233

    Phone: (832) 390-5434

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250827001330IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76126)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103904461View full group profile
NameSpecialtyState
General SurgeryTX
Nurse PractitionerTX
General SurgeryTX
Physician AssistantTX
Cardiac Surgery, General Surgery, Thoracic SurgeryTX
-TX
General SurgeryTX
Thoracic Surgery, Cardiac SurgeryTX
-TX
Vascular Surgery, Cardiac SurgeryTX

Reviews

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Frequently asked questions

What is the standard ID for REBECCA BUCKNER (PHYSICIAN ASSISTANT) in the U.S.?
In the U.S., REBECCA BUCKNER (PHYSICIAN ASSISTANT) is identified by NPI 1013809748.
Quick check: is REBECCA BUCKNER (PHYSICIAN ASSISTANT) active?
Public NPPES data shows REBECCA BUCKNER (PHYSICIAN ASSISTANT) with an active NPI status right now.
How should patients interpret REBECCA BUCKNER (PHYSICIAN ASSISTANT)'s specialty?
The extract shows Surgical Physician Assistant for REBECCA BUCKNER (PHYSICIAN ASSISTANT). Clinical services aligned with this taxonomy classification.
What city is tied to REBECCA BUCKNER (PHYSICIAN ASSISTANT)?
The directory associates REBECCA BUCKNER (PHYSICIAN ASSISTANT) with Fort Worth, Texas. Check all listed addresses for suites or satellite offices.
Why is information missing for REBECCA BUCKNER (PHYSICIAN ASSISTANT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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