NPIMap

Individual provider Active NPI

Evan R Butlin, M.D.

  • Pulmonary Disease Physician
  • Wyomissing, PA
National Provider Identifier
1396001087
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD481297 Issued in PA
Practice address
2608 Keiser Blvd
Wyomissing, PA 19610-3333
Phone
(610) 685-5864
Fax
(610) 929-1528
NPI assigned
Apr 6, 2012
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A126551 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101265286 VA
Pulmonary Disease Physician 207RP1001X 0101265286 VA
Pulmonary Disease Physician 207RP1001X MD481297 PA Primary

Addresses

Primary practice location

2608 Keiser Blvd
Wyomissing, PA 19610-3333

Mailing address

2608 Keiser Blvd
Wyomissing, PA 19610-3333
Phone (610) 685-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, PA2 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
I20190326000789 VA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7618106576 Reassigns benefits to 1 organization
I20230925000366 PA Practitioner - Pulmonary Disease 7618106576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Loma Linda University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Respiratory Specialists LTDGroup PAC ID 6204812076, 18 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

2608 Keiser Blvd
Wyomissing, PA 19610-3333
Phone (610) 685-5864

321 N Furnace St
Birdsboro, PA 19508-2057
Phone (610) 582-2250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126551CAMDInternal Medicine Physician
0101265286VAMDCritical Care Medicine (Internal Medicine) Physician
MD481297PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Apr 1, 2020 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Pulmonary Disease CurrentSince Apr 1, 2020 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Respiratory Specialists LTD Critical Care Medicine CurrentSince Dec 11, 2023 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Reading Hospital Internal Medicine Past Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

562 Shearer St
Ste 103
Greensburg, PA 15601
Phone (724) 850-3150

1 Mellon Way
Latrobe, PA 15650
Phone (724) 537-1207

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

2608 Keiser Blvd
Wyomissing, PA 19610
Phone (610) 929-5864

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • Direct secure messaging: ebutlin@respiratoryspecialists.medentdirect.com
  • Direct secure messaging: ebutlin121356@direct.rivhs.com

Organizations & group practices 7

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 12

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1396001087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 KEISER BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103333",
            "telephone_number": "610-685-5864",
            "fax_number": "610-929-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 KEISER BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103333",
            "telephone_number": "610-685-5864",
            "fax_number": "610-929-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLIN",
        "first_name": "EVAN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126551",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101265286",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101265286",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD481297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.