Individual provider Active NPI

Scott E Butler, PA-C

  • Physician Assistant
  • State College, PA
National Provider Identifier
1194725812
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003280L Issued in PA
Practice address
1700 Old Gatesburg Rd
Ste 100
State College, PA 16803-2276
Phone
(814) 237-3360
Fax
(814) 237-2130
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA003280L PA Primary

Addresses

Primary practice location

1700 Old Gatesburg Rd
Ste 100
State College, PA 16803-2276

Mailing address

1700 Old Gatesburg Rd
Ste 100
State College, PA 16803-2276
Phone (814) 237-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061019000506 PA Practitioner - Physician Assistant 6709882434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Nittany Medical CenterGroup PAC ID 2365353364, 45 clinicians

Practice addresses (Care Compare)

1800 E Park Ave
State College, PA 16803-6797
Phone (814) 231-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center CurrentSince Jan 1, 2015 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1700 Old Gatesburg Rd
Ste 100
State College, PA 16803
Phone (814) 237-3360

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1194725812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OLD GATESBURG RD",
            "address_2": "STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032276",
            "telephone_number": "814-237-3360",
            "fax_number": "814-237-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD GATESBURG RD",
            "address_2": "STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032276",
            "telephone_number": "814-237-3360",
            "fax_number": "814-237-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003280L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.