JAMES F BENCIVENGA MD
NPI 1659304434
Preventive Medicine - Occupational Medicine in Hartford, WI
NPI Status: Active since July 08, 2006
Contact Information
1640 E SUMNER ST
HARTFORD, WI
ZIP 53027
Phone: (262) 670-4350
Fax: (262) 670-4351
- Individual
- Male
- Preventive Medicine
- Occupational Medicine
- Accepts Insurance
- PECOS Enrolled
About JAMES BENCIVENGA
This page provides the complete NPI Profile along with additional information for James Bencivenga, a provider established in Hartford, Wisconsin with a medical specialization in Preventive Medicine, focusing in occupational medicine . The healthcare provider is registered in the NPI registry with number 1659304434 assigned on July 2006. The practitioner's primary taxonomy code is 2083X0100X with license number 52662-20 (WI). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1659304434
- Provider Name
- JAMES F BENCIVENGA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1640 E SUMNER ST HARTFORD, WI 53027
- Location Phone
- (262) 670-4350
- Location Fax
- (262) 670-4351
- Mailing Address
- 1640 E SUMNER ST HARTFORD, WI 53027
- Mailing Phone
- (262) 670-4350
- Mailing Fax
- (262) 670-4351
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-08-2006
- Last Update Date
- 12-03-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preventive Medicine Occupational Medicine
- Taxonomy Code
- 2083X0100X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 52662-20
- License State
- WI
- Taxonomy Description
- Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 7500 - HMO
- HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
- HMO Gold 1500 - HMO
- HMO Gold 2400 - HMO
- HMO HDHP Bronze 7200 - HMO
- HMO HDHP Silver 5400 - HMO
- HMO Silver 5000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 48837 | OTHER (01) | MN | LICENSE |
| 52662-20 | OTHER (01) | WI | LICENSE |
Medicare Participation & PECOS Enrollment Status
James Bencivenga is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 53027 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $123.69
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $30.92
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 5 | 9 | 3 | 0 | 4 | 4 | 3 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 10 | 9 | 6 | 0 | 8 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 0 + 9 + 6 + 0 + 8 + 4 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1659304434 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1538107842 | AURORA PHARMACY, INC. Organization | Pharmacy (Community/Retail Pharmacy) | 1640 E SUMNER ST SUITE 100 HARTFORD, WI 53027 (262) 670-4210 |
| 1912014465 | MS. ELAINE E LESKO MS Individual | Audiologist | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1306953708 | JOSEPH R PFOTENHAUER MD Individual | Internal Medicine | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1750498952 | MS. LINDA J SHIELDS APNP Individual | Nurse Practitioner | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1720155716 | AMY L SIMMONS RD Individual | Dietitian, Registered | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1801953328 | AURORA MEDICAL GROUP, INC. Organization | Durable Medical Equipment & Medical Supplies | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1134243850 | KRISTINE M ERICKSON PT Individual | Physical Therapist | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-7550 |
| 1942401237 | KATHERINE E DUCKERT SLP Individual | Speech-Language Pathologist | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4305 |
| 1184801680 | COLETTE E MURPHY CCC/SLP Individual | Speech-Language Pathologist | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4300 |
| 1417102989 | MS. KIMBERLY A BEIMEL PTA Individual | Physical Therapy Assistant | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4300 |
| 1467750166 | AURORA ADVANCED HEALTHCARE, INC. Organization | Durable Medical Equipment & Medical Supplies | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1003177429 | SARA C POUPORE NP Individual | Nurse Practitioner | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1083721609 | BRUCE EDWARD HICKMAN MD Individual | Family Medicine | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1487080560 | LISA MARIE CZERWINSKI RPH Individual | Pharmacist | 1640 E SUMNER ST SUITE100 HARTFORD, WI 53027 (262) 670-4210 |
| 1114034659 | DANIEL T KOPESKY DO Individual | Obstetrics & Gynecology | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1487940920 | AURORA MEDICAL CENTER OF WASHINGTON COUNTY, INC. Organization | Durable Medical Equipment & Medical Supplies | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4300 |
| 1205131521 | KATHRYN A FROHMADER M.S. CFY-SLP Individual | Speech-Language Pathologist | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4305 |
| 1740815844 | PATRICIA K BURMEISTER RN Individual | Registered Nurse (Diabetes Educator) | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1184633869 | PAUL V BULLIS MD Individual | Family Medicine | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
| 1235577008 | DR. STEVEN D SAMUEL D.C. Individual | Chiropractor | 1640 E SUMNER ST HARTFORD, WI 53027 (262) 670-4000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659304434, enumerated in the NPI registry as an "individual" on July 08, 2006
The provider is located at 1640 E Sumner St Hartford, Wi 53027 and the phone number is (262) 670-4350
The provider's speciality is Preventive Medicine with taxonomy code 2083X0100X with a focus in Occupational Medicine
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $123.69 with an average copayment of $30.92 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on July 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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