Individual provider Active NPI

Habib A Bhutta, MD

  • Surgery Physician
  • Laurel, MD
National Provider Identifier
1598858045
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0024364 Issued in MD
Practice address
14201 Laurel Park Dr Ste 102
Laurel, MD 20707-5203
Phone
(301) 490-3443
Fax
(301) 490-0200
NPI assigned
Oct 2, 2006
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0024364 MD Primary

Addresses

Primary practice location

14201 Laurel Park Dr Ste 102
Laurel, MD 20707-5203

Mailing address

14201 Laurel Park Dr Ste 102
Laurel, MD 20707-5203
Phone (301) 490-3443

Other identifiers 1

IdentifierTypeStateIssuer
781621900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101122001199 DC Practitioner - General Surgery 8224192513 Practice locations: Laurel, MD
I20150331000277 MD Practitioner - General Surgery 8224192513 Practice locations: Laurel, MD

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14201 Laurel Park Dr
Suite 102
Laurel, MD 20707-5203
Phone (301) 490-3443

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: habib.bhutta@habibabhuttamd.ehi.direct-ci.com
  • Direct secure messaging: hbhutta801430@direct.umm.edu

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1598858045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DR STE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075203",
            "telephone_number": "301-490-3443",
            "fax_number": "301-490-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DR STE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075203",
            "telephone_number": "301-490-3443",
            "fax_number": "301-490-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUTTA",
        "first_name": "HABIB",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0024364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "781621900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.