Provider Demographics
NPI:1538315114
Name:CARTAGENA-HERNANDEZ, BENIGNO (MD)
Entity type:Individual
Prefix:DR
First Name:BENIGNO
Middle Name:
Last Name:CARTAGENA-HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12205 S 78TH ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4787
Mailing Address - Country:US
Mailing Address - Phone:787-354-8736
Mailing Address - Fax:
Practice Address - Street 1:MERCY HOSPITAL SOUTHEAST
Practice Address - Street 2:1701 LACET ST
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701
Practice Address - Country:US
Practice Address - Phone:573-344-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-44898207R00000X, 208M00000X
NE30615208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA10026327300Medicaid
NE10026327300Medicaid
IA1538315114Medicaid