Individual provider Active NPI

David G. Butler, M.D.

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
National Provider Identifier
1316068448
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MA025704 Issued in NJ
Practice address
420 Grand Ave
Englewood, NJ 07631-4152
Phone
(201) 871-4040
Fax
(201) 871-7326
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA025704 NJ Primary

Addresses

Primary practice location

420 Grand Ave
Englewood, NJ 07631-4152

Mailing address

420 Grand Ave
Englewood, NJ 07631-4152
Phone (201) 871-4040

Other identifiers 3

IdentifierTypeStateIssuer
420503OtherNJCIGNA
1543103OtherNJUNITED HEALTHCARE
BP382OtherNJOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20100216000366 NJ Practitioner - Obstetrics/Gynecology 4880751619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York Downstate Medical Center, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

222 Cedar LN
Suite 303
Teaneck, NJ 07666-4313
Phone (201) 871-4040

408 37TH St
Union City, NJ 07087-4994
Phone (201) 864-4477

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA025704NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Medical Associates, PA CurrentSince Sep 1, 2014 Accepting new patients

Locations

420 Grand Ave
Ste 202
Englewood, NJ 07631
Phone (201) 871-4040

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

222 Cedar Ln
Ste 303
Teaneck, NJ 07666
Phone (201) 836-9696

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1316068448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314152",
            "telephone_number": "201-871-4040",
            "fax_number": "201-871-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314152",
            "telephone_number": "201-871-4040",
            "fax_number": "201-871-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "DAVID",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA025704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "420503",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1543103",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "BP382",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.