Individual provider Active NPI

Russell Jay Buttars, DPM

  • Foot & Ankle Surgery Podiatrist
  • Logan, UT
National Provider Identifier
1043428634
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
11633905-0501 Issued in UT
Practice address
2310 N 400 E Ste a
Logan, UT 84341-1796
Phone
(435) 787-2000
Fax
(435) 787-1913
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E 4727 CA
Foot & Ankle Surgery Podiatrist 213ES0103X EL 1582 CA
Foot & Ankle Surgery Podiatrist 213ES0103X 11633905-0501 UT Primary

Addresses

Primary practice location

2310 N 400 E Ste a
Logan, UT 84341-1796

Mailing address

2561 S 1560 W Ste B
Woods Cross, UT 84087-2361
Phone (801) 505-0821

Other practice location 1

1030 S Medical Dr Ste A
Brigham City, UT 84302-3281
Phone (435) 723-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200408000674 UT Practitioner - Podiatry 4981769528
I20220105000560 ID Practitioner - Podiatry 4981769528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Management and ConsultingGroup PAC ID 5496659245, 21 clinicians

Practice addresses (Care Compare)

44 N 1St
Preston, ID 83263-1326
Phone (208) 852-0137

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue191
Removal or shaving of skin growth59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4727CAMDCase Manager/Care Coordinator
E 4727CAMDFoot & Ankle Surgery Podiatrist
EL 1582CAMDFoot & Ankle Surgery Podiatrist
11633905-0501UTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Management and Consulting Podiatrist CurrentSince Jul 30, 2021 Accepting new patients

Locations

64 N 1st E
Ste 200
Preston, ID 83263
Phone (208) 852-3662

44 N 1st E
Preston, ID 83263
Phone (208) 852-0137

64 N 1st E
Preston, ID 83263
Phone (208) 852-3662

1030 S Medical Dr
Ste A
Brigham City, UT 84302
Phone (435) 723-4500

2310 N 400 E
Ste A
North Logan, UT 84341
Phone (435) 774-8547

Networks

  • UT PPO
  • UT PPO D-SNP

Interoperability endpoints

  • Direct secure messaging: russell.buttars.1@17373.direct.athenahealth.com
  • Direct secure messaging: rjb@alpineortho.emadirect.md

Organizations & group practices 1

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1043428634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 S 1560 W STE B",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840872361",
            "telephone_number": "801-505-0821",
            "fax_number": "801-505-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N 400 E STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411796",
            "telephone_number": "435-787-2000",
            "fax_number": "435-787-1913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 S Medical Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843023281",
            "country_code": "US",
            "telephone_number": "435-723-9700",
            "fax_number": "435-723-9710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTTARS",
        "first_name": "RUSSELL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E 4727",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL 1582",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "11633905-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.