Individual provider Active NPI

Cenon M Buencamino, MD

  • Diagnostic Radiology Physician
  • Madison, WI
National Provider Identifier
1699755579
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
40085 Issued in WI
Practice address
1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone
(608) 252-8000
Fax
(608) 283-7361
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 40085 WI Primary

Addresses

Primary practice location

1313 Fish Hatchery Rd
Madison, WI 53715-1911

Mailing address

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers 2

IdentifierTypeStateIssuer
34491100MedicaidWI
1699755579MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cbuencamino261543@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, PA2 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
I20040621000831 WI Practitioner - Diagnostic Radiology 7719962109 Reassigns benefits to 1 organization
I20241016002655 PA Practitioner - Diagnostic Radiology 7719962109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chambersburg Imaging Associates P.C.Group PAC ID 6406832211, 13 clinicians

Practice addresses (Care Compare)

144 S 8TH St
Suite 108
Chambersburg, PA 17201-2752
Phone (717) 263-1383

Hospital & facility affiliations

  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40085WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chambersburg Imaging Associates P.C. CurrentSince Sep 27, 2024 Accepting new patients
Beloit Radiology LTD Diagnostic Radiology CurrentSince May 31, 2020 Accepting new patients

Locations

144 S 8th St
Ste 108
Chambersburg, PA 17201
Phone (717) 262-2183

112 N 7th St
Chambersburg, PA 17201
Phone (717) 217-4300

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Interoperability endpoints

  • Direct secure messaging: cbuencamino459667@wellspan.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1699755579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENCAMINO",
        "first_name": "CENON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "40085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34491100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699755579",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbuencamino261543@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cbuencamino261543@direct-ehr-ssmhc.com",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.