Active NPI
Cassandra Buto-Colletti, DO
- Advanced Heart Failure and Transplant Cardiology Physician
- Columbia, SC
National Provider Identifier
1174563597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Heart Failure and Transplant Cardiology Physician
- License
- 83361
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 933619 | Medicaid | SC |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102204524 | VA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Richmond Specialty Care LLC | Cardiovascular Disease | Current | Accepting new patients |
| Bon Secours Medical Group Richmond Specialty Care LLC | Current | 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
- 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.
-
- Cardiovascular Disease Physician
- Richmond, VA
- NPI 1477112225
-
- Durable Medical Equipment & Medical Supplies
- Midlothian, VA
- NPI 1841029287
-
- Emergency Medicine Physician
- Forest Hills, NY
- NPI 1922031905
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.