Individual provider Active NPI

Cassandra Buto-Colletti, DO

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Columbia, SC
National Provider Identifier
1174563597
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
83361 Issued in SC
Practice address
6 Richland Medical Park Dr Ste 2100
Columbia, SC 29203-6864
Phone
(803) 434-8505
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 83361 SC
Cardiovascular Disease Physician 207RC0000X 0102204524 VA
Student in an Organized Health Care Education/Training Program 390200000X 0102204524 VA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 83361 SC Primary

Addresses

Primary practice location

6 Richland Medical Park Dr Ste 2100
Columbia, SC 29203-6864

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 434-8505

Other practice location 1

5875 Bremo Rd Ste 400C
Richmond, VA 23226-1928
Phone (804) 287-3550

Other identifiers 1

IdentifierTypeStateIssuer
933619MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241120004758 VA Practitioner - Cardiovascular Disease (Cardiology) 4981650264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0102204524VAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC Cardiovascular Disease CurrentSince Jan 2, 2025 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 2, 2025 Accepting new patients
Lifeco Medical, P.C. Past Accepting new patients

Locations

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5875 Bremo Rd
Ste 400C
Richmond, VA 23226
Phone (804) 287-3550

Interoperability endpoints

  • Direct secure messaging: cbutocolletti2733110@direct.bsmhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1174563597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-434-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RICHLAND MEDICAL PARK DR STE 2100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036864",
            "telephone_number": "803-434-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5875 Bremo Rd Ste 400C",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261928",
            "country_code": "US",
            "telephone_number": "804-287-3550",
            "fax_number": "804-281-7840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTO-COLLETTI",
        "first_name": "CASSANDRA",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "83361",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0102204524",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0102204524",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "SC",
            "license": "83361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "933619",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.