Organization Active NPI

Buttelman Medical Corporation

  • Internal Medicine Physician
  • Northridge, CA
National Provider Identifier
1093723595
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A47864 Issued in CA
Legal business name
BUTTELMAN MEDICAL CORPORATION
Practice address
17075 Devonshire St Ste 209
Northridge, CA 91325-5411
Phone
(818) 832-7802
Fax
(818) 832-7805
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Dr. Christopher Robert Buttelman, MDNPI 1437128840
Title
Physian/Owner
Phone
(818) 832-7802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A47864 CA Primary

Addresses

Primary practice location

17075 Devonshire St Ste 209
Northridge, CA 91325-5411

Mailing address

17075 Devonshire St Ste 209
Northridge, CA 91325-5411
Phone (818) 832-7802

Other identifiers 1

IdentifierTypeStateIssuer
00A478640MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000930 CA Part B Supplier - Clinic/Group Practice 7719968247 Receives reassigned benefits from 1 practitioner
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Locations

17075 Devonshire St
Ste 200
Northridge, CA 91325
Phone (818) 363-3105

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1093723595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 209",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255411",
            "telephone_number": "818-832-7802",
            "fax_number": "818-832-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 209",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255411",
            "telephone_number": "818-832-7802",
            "fax_number": "818-832-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTTELMAN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "BUTTELMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSIAN/OWNER",
        "authorized_official_telephone_number": "818-832-7802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A47864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A478640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.