Individual provider Active NPI

Tasso S Butler Jr., OD

  • Optometrist
  • Lewisburg, WV
National Provider Identifier
1205888757
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
658OD Issued in WV
Practice address
413 Greenbrier Vally Mall Dr
Suite 2
Lewisburg, WV 24901-1794
Phone
(304) 645-2799
Fax
(304) 647-3962
NPI assigned
May 16, 2006
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601000803 VA
Optometrist 152W00000X 658OD WV Primary

Addresses

Primary practice location

413 Greenbrier Vally Mall Dr
Suite 2
Lewisburg, WV 24901-1794

Mailing address

US RT 219
Greenbrier Valley Mall
Lewisburg, WV 24901
Phone (304) 645-2799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090625000038 WV Practitioner - Optometry 2668523077 Practice locations: Lewisburg, WV
I20101115001400 VA Practitioner - Optometry 2668523077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

413 Greenbrier Valley Mall Dr
Suite 2
Lewisburg, WV 24901-0237
Phone (304) 645-2799

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0601000803VAMDOptometrist
658ODWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Krishna Sankar M.D., P.C. CurrentSince Jan 19, 1990 Accepting new patients
Krishna Sankar M.D.,P.C. Optometrist CurrentSince Jan 19, 1990 Accepting new patients
Gregory C Mays M.D., P.L.C. PastSince May 29, 2012 Accepting new patients

Locations

201 Interstate Dr
Covington, VA 24426
Phone (540) 962-4621

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1205888757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US RT 219",
            "address_2": "GREENBRIER VALLEY MALL",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "304-645-2799",
            "fax_number": "304-647-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 GREENBRIER VALLY MALL DR",
            "address_2": "SUITE 2",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011794",
            "telephone_number": "304-645-2799",
            "fax_number": "304-647-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "TASSO",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601000803",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "658OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.