NPIMap

Individual provider Active NPI

Bradley T Butkovich, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Norfolk, VA
National Provider Identifier
1154372712
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
0101237415 Issued in VA
Practice address
6160 Kempsville Cir
Suite 200B
Norfolk, VA 23502-3933
Phone
(757) 321-3383
Fax
(757) 321-3332
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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 7

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

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Virginia Commonwealth University, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vann-Virginia Center for Orthopaedics PC 65 clinicians

Practice addresses (Care Compare)

6160 Kempsville Cir
Suite 200B
Norfolk, VA 23502-3945
Phone (757) 321-3300

Hospital & facility affiliations

  • Centerwell Home Health (VA Beach) Home health agency, Virginia Beach, VA, CCN 497271
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

Merit-based Incentive Payment System (MIPS)

Final score
92.32 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
87.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)23

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050628001419 VA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 1456397611 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101237415VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vann-Virginia Center for Orthopaedics PC Orthopaedic Surgery CurrentSince Dec 1, 2012 Accepting new patients
Vann-Virginia Center for Orthopaedics PC Orthopaedic Surgery CurrentSince Dec 1, 2012 Accepting new patients
Vann-Virginia Center for Orthopaedics PC Orthopaedic Surgery Past Accepting new patients
Tuckahoe Orthopaedic Associates, LTD Orthopaedic Surgery PastSince Dec 18, 2022 Accepting new patients

Locations

6160 Kempsville Cir
Ste 200B
Norfolk, VA 23502
Phone (757) 321-3383

1800 Camelot Dr
Ste 300
Virginia Beach, VA 23454
Phone (757) 321-3383

230 Clearfield Ave
Ste 124
Virginia Beach, VA 23462
Phone (757) 321-3383

Interoperability endpoints

  • Direct secure messaging: bradleybutkovichmd@aos.allscriptsdirect.net

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101237415 VA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101237415 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

6160 Kempsville Cir
Suite 200B
Norfolk, VA 23502-3933

Mailing address

230 Clearfield Ave
Suite 124
Virginia Beach, VA 23462-1832
Phone (757) 321-3383

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
C05501OtherVAMEDICARE GROUP PIN
1154372712MedicaidVA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 8, 2021.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1154372712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CLEARFIELD AVE",
            "address_2": "SUITE 124",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621832",
            "telephone_number": "757-321-3383",
            "fax_number": "757-321-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR",
            "address_2": "SUITE 200B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-321-3383",
            "fax_number": "757-321-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTKOVICH",
        "first_name": "BRADLEY",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101237415",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101237415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "C05501",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154372712",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.