Vidalia M Butler-Poku, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

33705 Issued in AZ

Practice address

270 E Hunt Hwy
10
San Tan Valley, AZ 85143-4962

Phone

(480) 987-5500

Fax

(480) 987-5507

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hera Health Medical Group - Az PLLCGroup PAC ID 8729458864, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vidalia.butler-poku.1@27149.direct.athenahealth.com

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.

• Hera Health Medical Group - Az PLLC

  • Maternal & Fetal Medicine Physician
  • San Tan Valley, AZ
  • NPI 1821728916
  Medicare reassignment Care Compare group NPD
• Womens Health Palace PLLC

  • Obstetrics & Gynecology Physician
  • Coolidge, AZ
  • NPI 1003313362
  NPD (past) Authorized official
• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  NPD (past)
• Medical Associates of Erie

  • Family Medicine Physician
  • Erie, PA
  • NPI 1164304903
  NPD (past)

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

• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1285639286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E HUNT HWY",
            "address_2": "10",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851434962",
            "telephone_number": "480-987-5500",
            "fax_number": "480-987-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E HUNT HWY",
            "address_2": "10",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851434962",
            "telephone_number": "480-987-5500",
            "fax_number": "480-987-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER-POKU",
        "first_name": "VIDALIA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "33705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941494",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charity Bubik, RN
• Tamara M Bulthuis, APRN-RNP
• Vilma M Burke, FNP
• Amy Burks
• Alyssa Danielle Bustos
• Christopher Ray Butler, D.C.
• Todd David Butler, D.D.S
• Brian Cafaro, MD
• Tiffany Cagle-Guthrie, RPSGT, RST, CCSH
• Calm Home LLC

• Obstetrics & Gynecology Physician in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.