Individual provider Active NPI

David Buttross III, MD

  • Psychiatry Physician
  • Lake Charles, LA
National Provider Identifier
1083615421
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
021316 Issued in LA
Practice address
333 Dr Michael Debakey Dr
Suite 220
Lake Charles, LA 70601-5887
Phone
(337) 478-9331
Fax
(337) 478-9828
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 021316 LA Primary

Addresses

Primary practice location

333 Dr Michael Debakey Dr
Suite 220
Lake Charles, LA 70601-5887

Mailing address

333 Dr Michael Debakey Dr
Suite 220
Lake Charles, LA 70601-5887
Phone (337) 478-9331

Other identifiers 1

IdentifierTypeStateIssuer
1680991MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000622 LA Practitioner - Psychiatry 4981645496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in Shreveport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Area Psychiatry LLCGroup PAC ID 7810938321, 13 clinicians

Practice addresses (Care Compare)

401 Dr Michael Debakey Dr
Suite 301
Lake Charles, LA 70601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021316LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Area Psychiatry LLC Psychiatry CurrentSince Apr 1, 2005 Accepting new patients
Allyson Warshaw, LCSW LLC Past Accepting new patients
Christus Health Southwestern Louisiana Past Accepting new patients

Locations

333 Dr Michael Debakey Dr
Ste 220
Lake Charles, LA 70601
Phone (337) 478-9828

401 Dr Michael Debakey Dr
Ste 301
Lake Charles, LA 70601

Organizations & group practices 3

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 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1083615421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 DR MICHAEL DEBAKEY DR",
            "address_2": "SUITE 220",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015887",
            "telephone_number": "337-478-9331",
            "fax_number": "337-478-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 DR MICHAEL DEBAKEY DR",
            "address_2": "SUITE 220",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015887",
            "telephone_number": "337-478-9331",
            "fax_number": "337-478-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTROSS",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "021316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1680991",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.