Individual provider Active NPI

Dennis J. Buono, D.O.

  • Adult Medicine Physician
  • Port Clinton, OH
National Provider Identifier
1144209156
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
34008701 Issued in OH
Practice address
2621 E Harbor Rd
Port Clinton, OH 43452-2607
Phone
(419) 732-9975
Fax
(419) 732-6415
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 34008701 OH Primary

Addresses

Primary practice location

2621 E Harbor Rd
Port Clinton, OH 43452-2607

Mailing address

2621 E Harbor Rd
Port Clinton, OH 43452-2607
Phone (419) 732-9975

Other identifiers 1

IdentifierTypeStateIssuer
2634466MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34008701OHMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesculapius PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144209156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 E HARBOR RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522607",
            "telephone_number": "419-732-9975",
            "fax_number": "419-732-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 E HARBOR RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522607",
            "telephone_number": "419-732-9975",
            "fax_number": "419-732-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONO",
        "first_name": "DENNIS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "34008701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2634466",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.