NPIMap

Individual provider Active NPI

Brian Anthony Butkus, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1013967538
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9987 Issued in MN
Practice address
1001 E Superior St
Suite L201
Duluth, MN 55802-2207
Phone
(218) 249-3057
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9987 MN Primary

Addresses

Primary practice location

1001 E Superior St
Suite L201
Duluth, MN 55802-2207

Mailing address

1001 E Superior St
Suite L201
Duluth, MN 55802-2207
Phone (218) 249-3057

Other identifiers 1

IdentifierTypeStateIssuer
819684200MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000403 MN Practitioner - Physician Assistant 2365479292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1001 E Superior St
Suite 201
Duluth, MN 55802-2228
Phone (218) 249-7980

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Aspirus Lake View Hospital Hospital, Two Harbors, MN, CCN 241308
  • Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364
  • Tamarack Health Ashland Medical Center Hospital, Ashland, WI, CCN 521359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Jan 28, 2022 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Jan 28, 2022 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1001 E Superior St
Ste 201
Duluth, MN 55802
Phone (218) 249-3057

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1001 E Superior St
Ste L201
Duluth, MN 55802
Phone (218) 249-3057

Interoperability endpoints

  • Direct secure messaging: bbutkus237375@direct.aspirus.org

Organizations & group practices 4

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.

Hospital & facility affiliations 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1013967538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "SUITE L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "SUITE L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTKUS",
        "first_name": "BRIAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "819684200",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1001 E Superior St",
            "address_2": "Suite L201",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.