Individual provider Active NPI

Amy C. P. Buencamino, M.D.

  • Pediatrics Physician
  • Madison, WI
National Provider Identifier
1619939493
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
46409-020 Issued in WI
Practice address
4410 Regent St
Madison, WI 53705-4901
Phone
(608) 233-9746
Fax
(608) 233-0026
NPI assigned
Apr 5, 2006
Last updated
Apr 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 46409-020 WI Primary

Addresses

Primary practice location

4410 Regent St
Madison, WI 53705-4901

Mailing address

4410 Regent St
Madison, WI 53705-4901
Phone (608) 233-9746

Other identifiers 1

IdentifierTypeStateIssuer
34510600MedicaidWI

Other names 1

  • Dr. Amy C Pivovar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040913001381 WI Practitioner - Pediatric Medicine 4789651357 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46409-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Associated Physicians, LLP Pediatrics CurrentSince Jun 30, 2009 Accepting new patients

Locations

4410 Regent St
Madison, WI 53705
Phone (608) 233-9746

Interoperability endpoints

  • Direct secure messaging: abuencamino263333@direct.unitypoint.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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1619939493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054901",
            "telephone_number": "608-233-9746",
            "fax_number": "608-233-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054901",
            "telephone_number": "608-233-9746",
            "fax_number": "608-233-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENCAMINO",
        "first_name": "AMY",
        "middle_name": "C. P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "46409-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34510600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "PIVOVAR",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.