Individual provider Active NPI

Krystal Buttitta, PA-C

  • Physician Assistant
  • West Allis, WI
National Provider Identifier
1417638362
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7480 Issued in WI
Practice address
6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone
(414) 257-8577
Fax
(414) 257-8505
NPI assigned
Jul 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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 7480 WI Primary

Addresses

Primary practice location

6609 W Greenfield Ave
West Allis, WI 53214-4958

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1190 Waianuenue Ave
Hilo, HI 96720-2094
Phone (808) 932-3730

Other identifiers 1

IdentifierTypeStateIssuer
100421875MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kbuttitta356018@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031003765 HI Practitioner - Physician Assistant 3678929304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 432-3000

16 -523 Keaau Pahoa Rd
Keaau, HI 96749-8156
Phone (808) 932-3830

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD1289HIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Sep 19, 2023 Accepting new patients
Kau Hospital CurrentSince Sep 19, 2023 Accepting new patients

Locations

1285 Waianuenue Ave
#2
Hilo, HI 96720

1285 Waianuenue Ave
Fl 2
Hilo, HI 96720
Phone (808) 932-3940

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

16-523 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 932-3801

Organizations & group practices 2

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 2

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": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1417638362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144958",
            "telephone_number": "414-257-8577",
            "fax_number": "414-257-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 Waianuenue Ave",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967202094",
            "country_code": "US",
            "telephone_number": "808-932-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTTITTA",
        "first_name": "KRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100421875",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbuttitta356018@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.