Active NPI
Bruce H Camilleri, MD
- Hospitalist Physician
- Madison, WI
National Provider Identifier
1912938333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 61509
- Practice address
- 700 S Park St
Madison, WI 53715-1830 - Phone
- (608) 251-6100
- Fax
- (608) 258-6259
- NPI assigned
- Jul 5, 2006
- Last updated
- Oct 3, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 32176-20 | WI | |
| Hospitalist Physician | 208M00000X | 61509 | AZ | Primary |
Addresses
Primary practice location
700 S Park St
Madison, WI 53715-1830
Mailing address
700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912938333 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bcamilleri262901@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
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32176-20 | WI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Physicians Group-Pannu PLLC | Internal Medicine | Current | Accepting new patients |
| Advanced Healthcare SC | Internal Medicine | Past | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Internal Medicine | Past | Accepting new patients |
Locations
5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111
37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000
333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161
Interoperability endpoints
- bcamilleri262901@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
- Hospitalist Physician
- Greenwood Village, CO
- NPI 1891236584
Internal Medicine, WI
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1154371847
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1912938333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100",
"fax_number": "608-258-6259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100",
"fax_number": "608-258-6259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMILLERI",
"first_name": "BRUCE",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "32176-20",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "61509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912938333",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bcamilleri262901@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "bcamilleri262901@direct-ehr-ssmhc.com",
"address_1": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"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": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.