NPIMap

Individual provider Active NPI

Rezkalla Butros, MD

  • Internal Medicine Physician
  • Mt. Sterling, KY
National Provider Identifier
1023037082
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34280 Issued in KY
Practice address
148 Skyview Drive
Mt. Sterling, KY 40351-1300
Phone
(859) 499-0717
Fax
(859) 499-0926
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34280 KY Primary
Nephrology Physician 207RN0300X 34280 KY

Addresses

Primary practice location

148 Skyview Drive
Mt. Sterling, KY 40351-1300

Mailing address

148 Skyview Drive
Mt. Sterling, KY 40351-1300
Phone (859) 499-0717

Other identifiers 3

IdentifierTypeStateIssuer
65938888MedicaidKY
31-001050MedicaidKY
64015977MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040513000932 KY Practitioner - Internal MedicinePractitioner - Nephrology 1557268331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Means Adult Primary Care Clinic of Kentucky PLLCGroup PAC ID 5395642177, 9 clinicians

Practice addresses (Care Compare)

1011 Brandy LN
Suite a
Richmond, KY 40475-8441
Phone (859) 286-7555

1145 W Lexington Ave
Suite a
Winchester, KY 40391-1290
Phone (859) 744-0301

148 Skyview Dr
Mt Sterling, KY 40353-1496
Phone (859) 499-0717

Hospital & facility affiliations

  • FMC - Winchester Dialysis facility, Winchester, KY, CCN 182602
  • FMC - Mt. Sterling Dialysis facility, Mount Sterling, KY, CCN 182555
  • Dialyze Direct Louisville, KY Dialysis facility, Louisville, KY, CCN 182646
  • St Claire Medical Center Home Health Home health agency, Morehead, KY, CCN 187037
  • Amedisys SP-Ky, LLC Dba Adoration Home Health Home health agency, Mount Sterling, KY, CCN 187093
  • Clark Regional Medical Center Hospital, Winchester, KY, CCN 180092
  • Saint Joseph Mount Sterling Hospital, Mount Sterling, KY, CCN 180064
  • Saint Joseph East Hospital, Lexington, KY, CCN 180143
  • Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010
  • Baptist Health Lexington Hospital, Lexington, KY, CCN 180103
  • Mt. Sterling Health & Rehab, LLC Nursing home, Mount Sterling, KY, CCN 185242
  • Ridgeway Nursing & Rehabilitation Facility Nursing home, Owingsville, KY, CCN 185254

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Means Adult Primary Care Clinic of Kentucky PLLC Internal Medicine CurrentSince Aug 1, 2000 Accepting new patients
Means Adult Primary Care Clinic of Kentucky PLLC Internal Medicine CurrentSince Sep 1, 2003 Accepting new patients
Rural Health PLLC Internal Medicine CurrentSince May 12, 2018 Accepting new patients
Regency Care of Mount Sterling LLC Past Accepting new patients
Ridgeway NRF Operations, LLC Past Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients

Locations

245 Prince Royal Dr
Ste A
Berea, KY 40403
Phone (859) 200-9640

784 Highway 36
Frenchburg, KY 40322
Phone (606) 768-9190

125 Sterling Way
Mt Sterling, KY 40353
Phone (859) 498-3343

148 Skyview Dr
Mt Sterling, KY 40353
Phone (859) 499-0717

1107 Indian Mound Dr
Ste D
Mt Sterling, KY 40353
Phone (859) 432-1064

406 Wyoming Rd
Owingsville, KY 40360
Phone (606) 674-6613

1011 Brandy Ln
Ste A
Richmond, KY 40475
Phone (859) 286-7555

1145 W Lexington Ave
Ste A
Winchester, KY 40391
Phone (859) 744-0301

Interoperability endpoints

  • Direct secure messaging: rezkalla.butros@mapccokp.eclinicaldirectplus.com
  • Direct secure messaging: rai8959@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/FJEJAD/Endpoint/FJEJAD

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ridgeway Nursing and Rehabilitation FacilityOwingsville, KY, CCN 185254 Skilled nursing facility Adp of the SNF Nov 14, 2019
Means Adult Primary Care Clinic of Kentucky PLLCMount Sterling, KY, CCN 183839 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)		 Jul 25, 2019
Jul 25, 2019
Jul 25, 2019
Jul 25, 2019
Means Adult Primary Care Clinic of Kentucky PLLCWinchester, KY, CCN B03948 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 6, 2003
Means Adult Primary Care Clinic of Kentucky PLLCRichmond, KY, CCN B03963 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)		 Feb 6, 2003
Feb 6, 2003
Feb 6, 2003
Feb 6, 2003

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1023037082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 SKYVIEW DRIVE",
            "city": "MT. STERLING",
            "state": "KY",
            "postal_code": "403511300",
            "telephone_number": "859-499-0717",
            "fax_number": "859-499-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 SKYVIEW DRIVE",
            "city": "MT. STERLING",
            "state": "KY",
            "postal_code": "403511300",
            "telephone_number": "859-499-0717",
            "fax_number": "859-499-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTROS",
        "first_name": "REZKALLA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34280",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "34280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65938888",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31-001050",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64015977",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Sterling, KY

Sources for this page

Verify at the official NPI Registry.