NPIMap

Individual provider Active NPI

John Winston Butler, PA-C

  • Physician Assistant
  • Farmington, NM
National Provider Identifier
1285100453
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2019-0091 Issued in NM
Practice address
2300 E 30TH St Ste C2
Farmington, NM 87401-8991
Phone
(505) 801-9733
NPI assigned
Oct 16, 2018
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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 PA2019-0091 NM Primary

Addresses

Primary practice location

2300 E 30TH St Ste C2
Farmington, NM 87401-8991

Mailing address

2300 E 30TH St Ste C2
Farmington, NM 87401-8991
Phone (505) 324-1000

Other practice location 1

3301 Crescent Ave
Farmington, NM 87401-4130
Phone (505) 801-9733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200129002995 NM Practitioner - Physician Assistant 2163858762 Reassigns benefits to 2 organizations
I20250611000560 TX Practitioner - Physician Assistant 2163858762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinon Family Practice PCGroup PAC ID 1658399936, 9 clinicians
Rosebud Indian Health ServiceGroup PAC ID 6901704055, 76 clinicians
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

2300 E 30TH St
BLDG C2
Farmington, NM 87401-8991
Phone (505) 324-1000

400 Soldier Creek Dr
Rosebud, SD 57570-8502
Phone (918) 457-8945

6 Rd
Suite 7586
Bloomfield, NM 87413-4934
Phone (505) 368-6401

PO Box
Suite 400
Rosebud, SD 57570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.44 of 100Reported as group
Quality
64
Promoting interoperability
100
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2019-0091NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates PA CurrentSince Nov 7, 2023 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 27, 2025 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 27, 2025 Accepting new patients
Rosebud Indian Health Service CurrentSince Sep 8, 2025 Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

2300 E 30th St
Bldg D-101
Farmington, NM 87401
Phone (505) 327-1400

Organizations & group practices 8

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 8

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1285100453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST STE C2",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-324-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST STE C2",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-801-9733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Crescent Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874014130",
            "country_code": "US",
            "telephone_number": "505-801-9733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JOHN",
        "middle_name": "WINSTON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2024-04-30",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2019-0091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.