Organization Active NPI

Daljit Buttar MD PC

  • Interventional Pain Medicine Physician
  • Raleigh, NC
National Provider Identifier
1518197839
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
31714 Issued in NC
Legal business name
DALJIT BUTTAR MD PC
Practice address
4201 Lake Boone TRL
Suite 100
Raleigh, NC 27607-7512
Phone
(919) 510-0688
NPI assigned
Jul 21, 2009
Last updated
Jul 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Authorized official

Name
Daljit S Buttar, MDNPI 1295884740
Title
Director
Phone
(919) 510-0688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 31714 NC
Interventional Pain Medicine Physician 208VP0014X 31714 NC Primary

Addresses

Primary practice location

4201 Lake Boone TRL
Suite 100
Raleigh, NC 27607-7512

Mailing address

4201 Lake Boone TRL
Suite 100
Raleigh, NC 27607-7512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090814000402 NC Part B Supplier - Clinic/Group Practice 8224182944 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0992760Daljit Buttar MD PC4201 Lake Boone TRL Ste 100, Raleigh, NC 27607Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory

Locations

8179 Ardrey Kell Rd
Ste 102
Charlotte, NC 28277
Phone (704) 841-1122

4201 Lake Boone Trl
Ste 100
Raleigh, NC 27607
Phone (919) 510-0688

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1518197839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-510-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALJIT BUTTAR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "BUTTAR",
        "authorized_official_first_name": "DALJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-510-0688",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "31714",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "31714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.