Individual provider Active NPI

Roxanne M. Buterakos, CNP

  • Nurse Practitioner
  • Flint, MI
National Provider Identifier
1588643175
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704185591 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 262-9000
NPI assigned
Jan 11, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 4704185591 MI
Nurse Practitioner 363L00000X 4704185591 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

1 Hurley PLZ
Flint, MI 48503-5902

Other identifiers 3

IdentifierTypeStateIssuer
3433384MedicaidMI
0B51149OtherMIBLUE SHIELD
0N84570005OtherMIMEDICARE

Other names 1

  • Roxanne M. Shelenberger Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbuterakos1859@direct.hurleymc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040918000066 MI Practitioner - Nurse Practitioner 6901874973 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, shared by 10 NPIs, 336 clinicians

Practice addresses (Care Compare)

1 Hurley Plasa
9W Hurley Maternal Fetal Medicine
Flint, MI 48503-5902
Phone (810) 262-4787

1 Hurley Plaza
Attn Professional Billing Dept
Flint, MI 48503-5902

1 Hurley Plaza Attn Pro Billing Dept
Flint, MI 48503-5902

1 Hurley Plaza Ground N Clinic
Hurley Nurse Practitioner Group
Flint, MI 48503-5902
Phone (810) 262-9191

1 Hurley PLZ
Flint, MI 48503-5902

6140 Rashelle Dr
Flint, MI 48507-3936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704185591MIMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center Nurse Practitioner CurrentSince Nov 1, 2004 Accepting new patients
Hurley Health Services CurrentSince Feb 16, 2017 Accepting new patients
Hemant T Thawani MD PLLC CurrentSince Apr 13, 2022 Accepting new patients
Hurley Health Services Nurse Practitioner CurrentSince Feb 16, 2017 Accepting new patients
Hurley Medical Center CurrentSince Nov 1, 2004 Accepting new patients
Hurley Medical Center CurrentSince Sep 9, 2013 Accepting new patients
Hurley Medical Center Current Accepting new patients
Stat Care PC Past Accepting new patients
Statcare PC Nurse Practitioner Past Accepting new patients
Hurley Medical Center Past Accepting new patients
Michigan Maternal Fetal Medicine PLC PastSince Apr 13, 2022 Accepting new patients

Locations

4272 W Vienna Rd
Clio, MI 48420
Phone (810) 687-2850

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1 Hurley Plz
#3D
Flint, MI 48503
Phone (810) 262-6046

1125 S Linden Rd
Ste 210
Flint, MI 48532
Phone (810) 230-3370

2 Hurley Plz
Ste 212
Flint, MI 48503
Phone (810) 257-9682

8359 Office Park Dr
Grand Blanc, MI 48439
Phone (877) 347-7978

9450 S Saginaw Rd
Ste G
Grand Blanc, MI 48439
Phone (810) 603-9391

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

Interoperability endpoints

  • Direct secure messaging: rbuterakos1859@direct.hurleymc.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1588643175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERAKOS",
        "first_name": "ROXANNE",
        "middle_name": "M.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MI",
            "license": "4704185591",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704185591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3433384",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0B51149",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0N84570005",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbuterakos1859@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "1 Hurley Plz",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485035902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "SHELENBERGER",
            "middle_name": "M.",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.