Individual provider Active NPI

Philip Miles Buttaravoli, M.D.

  • Emergency Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1003878653
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0056675 Issued in FL
Practice address
755 27TH Ave SW
Suite 9
Vero Beach, FL 32968-4200
Phone
(772) 299-0909
Fax
(772) 299-0989
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0056675 FL Primary

Addresses

Primary practice location

755 27TH Ave SW
Suite 9
Vero Beach, FL 32968-4200

Mailing address

8636 Falcon Green Dr
West Palm Beach, FL 33412-1576
Phone (561) 775-3388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0056675FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Center Walk-in Clinic LLC Past Accepting new patients
Floridian Emergency Specialists, LLC Emergency Medicine PastSince Jan 26, 2020 Accepting new patients
Town & Country Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Palms of Pasadena Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Berner ER Services Partnership Emergency Medicine Past Accepting new patients
JD Psychiatric Services Inc Past Accepting new patients
Ipn Emergency Physicians of North Florida PA Emergency Medicine Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1003878653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8636 FALCON GREEN DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334121576",
            "telephone_number": "561-775-3388",
            "fax_number": "561-622-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 27TH AVE SW",
            "address_2": "SUITE 9",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329684200",
            "telephone_number": "772-299-0909",
            "fax_number": "772-299-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTARAVOLI",
        "first_name": "PHILIP",
        "middle_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0056675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.