Michael S. Butchko, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6315 Issued in MN

Practice address

2265 Como Ave
Saint Paul, MN 55108-1737

Phone

(651) 645-5323

NPI assigned

Jul 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emily Program P CGroup PAC ID 5193623254, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Emily Program P C

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Paul, MN
  • NPI 1528165065
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1386166353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11145 BALTIMORE ST NE UNIT G",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737",
            "telephone_number": "651-645-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHKO",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "6315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol L Busman, CNS
• Janelle Melody Bussert, MT-BC
• Barbara L Butcher, MD
• Krystal Ann Butcher, PA
• Shirley Rae Butcher, LPCC, LADC
• Michael S Butler, PA-C
• Robert R Butler Jr., MD
• Shamara Butler
• Shelley Joan Butler, PA-C
• Ann Buttermann, MD

• Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.