PAUL H BONUCCI, MD — NPI 1922114677 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine

CMS-1500 Box 24J / 33a • NPI

1922114677

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2083A0300X (CMS 84)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine — Addiction Medicine

Box 32 Service Location & ZIP+4

2128 N MAIN ST, PRINCETON, IL, 61356-9728

✓ 9-Digit EDI 837 ZIP+4 (61356-9728)

Practice Phone & Referral Fax

(815) 875-2273

Fax: (815) 207-8682

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922114677 (PAUL H BONUCCI, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922114677` (NPI-1 Individual Practitioner)
Provider / Legal Name	PAUL H BONUCCI, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine — Addiction Medicine NUCC Code: `2083A0300X` (Preventive Medicine, Addiction Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2128 N MAIN ST, PRINCETON, IL, 61356-9728
Practice Telephone / Fax	Tel: (815) 875-2273 \| Fax: (815) 207-8682
Administrative Mailing Address	1124 PRAIRIE LN S, PRINCETON, IL, 61356-2383
Enumeration & Last Sync	Enumerated: 2006-08-22 \| CMS Record Updated: 2025-06-09

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2128 N MAIN ST, PRINCETON, IL, 61356-9728

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Plain-English Taxonomy & CMS Crosswalk (2083A0300X)

What Does Taxonomy Code 2083A0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2083A0300X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine — Addiction Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 84 (Physician/Preventive Medicine)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Preventive Medicine, Addiction Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (PAUL H BONUCCI, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2083A0300X` — Preventive Medicine, Addiction Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine — Addiction Medicine	State: IL \| License: `036100221` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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PAUL H BONUCCI, MD (NPI #1922114677)