Charles M Butrey, MD
Individual provider Active NPI Family Medicine Physician · Avon, OH
NPI 1013129394 · NPPES record last updated Dec 17, 2020
Key facts
- NPI
- 1013129394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35058431 (OH)
- Practice address
- 1480 Center Rd
Suite a
Avon, OH 44011-1239 - Phone
- (440) 937-4600
- Fax
- (440) 937-4605
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Wright State University Boonshoft School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- University Primary Care Practices Inc
Practice addresses (Care Compare)
11100 Euclid Ave
Cleveland, OH 44106-1716
158 W Main Rd
Conneaut, OH 44030-2039
Hospital & facility affiliations
- University Hospital Home Care Services, Inc
- University Hospitals - Elyria Medical Center
- Uh St John Medical Center
- Uh Cleveland Medical Center
- Mercy Regional Medical Center
- Parma Community General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 59 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100524000532 | OH | Practitioner - Family Practice | 2567508898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35058431 | OH | MD | Family Medicine Physician |
Practice roles (5 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Primary Care Practices Inc | Family Medicine | Current |
Accepting new patients |
| University Primary Care Practices Inc | Current | Accepting new patients | |
| University Primary Care Practices Inc | Current |
Accepting new patients | |
| University Hospitals Medical Group Inc | Past | Accepting new patients | |
| University Primary Care Practices | Past | Accepting new patients |
Locations
158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960
Networks
- OH PPO
- devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
- KY PPO
- devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
- devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
- KY PPO C-SNP
- devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
Interoperability endpoints
- cbutrey21053@ehrdirect.uhhospitals.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35058431 | OH | Yes |
Addresses
Primary practice location
1480 Center Rd
Suite a
Avon, OH 44011-1239
Mailing address
PO Box 636643
Cincinnati, OH 45263-6643
Phone (440) 989-3801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3025372 | Medicaid | OH | |
| 0782612 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | charlesbutrey@uhps.allscriptsdirect.net |
Other providers in Avon, OH
- Robert Bullock
- Timothy J Bungo
- Kimberly Bunton
- Eric Burgess
- Kathleen Burkhart
- Ellen M Button
- Jaime L Cabot
- Stephanie G Callander
- Mary Capelety
- Olivia Caplan
All providers in Avon, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.