Guy Andrew Buonincontro, D.O.
Individual provider Active NPI Family Medicine Physician · New Lisbon, NJ
NPI 1497829469 · NPPES record last updated Jul 29, 2016
Key facts
- NPI
- 1497829469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MB24073 (NJ)
- Practice address
- 104 Route 72 East
New Lisbon, NJ 08064-0130 - Phone
- (609) 726-1000
- Fax
- (609) 726-1387
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110728000350 | NJ | Practitioner - Family Practice | 3274701768 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB24073 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New Jersey Omb Centralized Payroll | Current |
Accepting new patients | |
| Berlin Family Practice Associates | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MB24073 | NJ | Yes |
| Family Medicine Physician | 207Q00000X | 25MB02407300 | NJ |
Addresses
Primary practice location
104 Route 72 East
New Lisbon, NJ 08064-0130
Mailing address
11 Pendleton Dr
Cherry Hill, NJ 08003-1919
Phone (856) 424-1489
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 551596B1G | Other | NJ | MEDICARE BILLING NO. |
Other names
- Guy A Buonincontro
Other providers in New Lisbon, NJ
- Neil Benson
- Sangeeta Buddala
- County of Burlington
- County of Burlington
- Hemlata Kiritkumar Desai
- Essam El-Harazy
- Keith James Keefer
All providers in New Lisbon, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.