Individual provider Active NPI

Guy Andrew Buonincontro, D.O.

  • Family Medicine Physician
  • New Lisbon, NJ
National Provider Identifier
1497829469
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB24073 Issued in 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
Last updated
Jul 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB24073 NJ Primary
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 names 1

  • Guy A Buonincontro Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110728000350 NJ Practitioner - Family Practice 3274701768 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB02407300NJMDFamily Medicine Physician
MB24073NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll CurrentSince Jun 29, 2016 Accepting new patients
Berlin Family Practice Associates Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1497829469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PENDLETON DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031919",
            "telephone_number": "856-424-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ROUTE 72 EAST",
            "city": "NEW LISBON",
            "state": "NJ",
            "postal_code": "080640130",
            "telephone_number": "609-726-1000",
            "fax_number": "609-726-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONINCONTRO",
        "first_name": "GUY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB24073",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB02407300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUY",
            "last_name": "BUONINCONTRO",
            "middle_name": "A",
            "credential": "D.O,",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Lisbon, NJ

Sources for this page

Verify at the official NPI Registry.