Individual provider Active NPI

Samuel D Buonocore, M.D.

  • Plastic Surgery Physician
  • Hartford, CT
National Provider Identifier
1275701237
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
49919 Issued in CT
Practice address
1000 Asylum Ave
Suite 4301
Hartford, CT 06105
Phone
(860) 714-9623
NPI assigned
Feb 13, 2008
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 49919 CT Primary

Addresses

Primary practice location

1000 Asylum Ave
Suite 4301
Hartford, CT 06105

Mailing address

1000 Asylum Ave
Suite 4301
Hartford, CT 06105-1770
Phone (860) 714-9623

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbuonocore9681@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000232 CT Practitioner - Plastic and Reconstructive Surgery 2567626997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
State University of Ny Upstate Medical University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Asylum Ave
Hartford, CT 06105-1702

114 Woodland St
Hartford, CT 06105-1208

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy13
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49919CTMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 1, 2012 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 1, 2012 Accepting new patients

Locations

1000 Asylum Ave
Ste 4301
Hartford, CT 06105
Phone (860) 241-0870

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1000 Asylum Ave
Ste 3207
Hartford, CT 06105
Phone (860) 241-0870

Interoperability endpoints

  • Direct secure messaging: sbuonocore2367090@direct.trinity-health.org

Organizations & group practices 2

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1275701237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 4301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 4301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONOCORE",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "49919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbuonocore9681@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 Asylum Ave",
            "address_2": "suite 4301",
            "city": "hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.