Individual provider Active NPI

Benjamin Bukey

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1598294696
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036151302 Issued in IL
Practice address
612 N 11TH St
Quincy, IL 62301-2662
Phone
(217) 224-9484
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036151302 IL Primary

Addresses

Primary practice location

612 N 11TH St
Quincy, IL 62301-2662

Mailing address

1005 Broadway St
Quincy, IL 62301-2834

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200401003076 IL Practitioner - Family Practice 3173892684 Reassigns benefits to 1 organization
I20240726000273 UT Practitioner - Family Practice 3173892684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2400 N Washington Blvd
North Ogden, UT 84414-7233
Phone (801) 779-6200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Sep 1, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jul 1, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jul 1, 2021 Accepting new patients

Locations

612 N 11th St
Quincy, IL 62301
Phone (217) 224-9484

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1598294696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKEY",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036151302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.