NPIMap

Individual provider Active NPI

Mujtaba I Butt, M.D.

  • Gastroenterology Physician
  • Orange Park, FL
National Provider Identifier
1194819474
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME116837 Issued in FL
Practice address
1465 Kingsley Ave
Suite 1101
Orange Park, FL 32073-4504
Phone
(904) 264-9797
Fax
(904) 264-4644
NPI assigned
Oct 3, 2006
Last updated
Sep 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME116837 FL Primary

Addresses

Primary practice location

1465 Kingsley Ave
Suite 1101
Orange Park, FL 32073-4504

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004

Other identifiers 2

IdentifierTypeStateIssuer
009259400MedicaidFL
003136488BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130830000351 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 1759483183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

805 Wells Rd
Orange Park, FL 32073-2301
Phone (904) 264-9797

836 Prudential Dr
Suite 801
Jacksonville, FL 32207-8335
Phone (904) 288-0433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy162
Upper gastrointestinal (GI) endoscopy for acid reflux408

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Borland Groover Clinic, PA Gastroenterology CurrentSince Aug 1, 2013 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Holyoke Medical Center, Inc. PastSince Oct 24, 1995 Accepting new patients

Locations

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

1465 Kingsley Ave
Ste 1101
Orange Park, FL 32073
Phone (904) 264-9797

805 Wells Rd
Orange Park, FL 32073
Phone (904) 264-9797

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mujtaba.butt.p1@direct.bgclinic.nextgenshare.com

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, 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1194819474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KINGSLEY AVE",
            "address_2": "SUITE 1101",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734504",
            "telephone_number": "904-264-9797",
            "fax_number": "904-264-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTT",
        "first_name": "MUJTABA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME116837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009259400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136488B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.