NPIMap

Organization Active NPI

Olaf Butchma DO PC

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1164054524
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OLAF BUTCHMA DO PC
Practice address
3617 Parsons Blvd
Flushing, NY 11354-5931
Phone
(516) 697-8387
Fax
(516) 365-1476
NPI assigned
Feb 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Dr. Olaf Butchma, DONPI 1326037474
Title
President
Phone
(516) 697-8387

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 Primary

Addresses

Primary practice location

3617 Parsons Blvd
Flushing, NY 11354-5931

Mailing address

PO Box 367
Manhasset, NY 11030-0367
Phone (516) 697-8387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200914000864 NY Part B Supplier - Clinic/Group Practice 5597183244 Receives reassigned benefits from 25 practitioners
Practice locations: Westhampton, NY; West Islip, NY; West Babylon, NY; Middle Island, NY; Holtsville, NY; Hempstead, NY; Flushing, NY; Brooklyn, NY…

National Provider Directory

National Provider Directory

Locations

5537 Expressway Dr N
Holtsville, NY 11742
Phone (631) 758-3336

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1164054524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110300367",
            "telephone_number": "516-697-8387",
            "fax_number": "516-365-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545931",
            "telephone_number": "516-697-8387",
            "fax_number": "516-365-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLAF BUTCHMA DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "BUTCHMA",
        "authorized_official_first_name": "OLAF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-697-8387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.