Active NPI
Pamela J. Butler, M.D.
- Dermatology Physician
- Menomonee Falls, WI
National Provider Identifier
1619907169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 32256
- Practice address
- N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810 - Phone
- (262) 251-7500
- Fax
- (262) 251-7128
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 32256 | WI | Primary |
Addresses
Primary practice location
N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32036100 | Medicaid | WI | |
| P00449461 | Other | WI | RR MEDICARE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pbutler522@direct.myadvocateaurora.org | ||
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080128000662 | WI | Practitioner - Dermatology | 2365524410 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32256 | WI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Healthcare SC | Dermatology | Past | Accepting new patients |
Interoperability endpoints
- pbutler522@direct.myadvocateaurora.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1619907169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N84W16889 MENOMONEE AVE",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530512810",
"telephone_number": "262-251-7500",
"fax_number": "262-251-7128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "PAMELA",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "32256",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32036100",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00449461",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pbutler522@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "N84W16889 Menomonee Ave",
"city": "Menomonee Falls",
"state": "WI",
"country_code": "US",
"postal_code": "530512810",
"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": "N84W16889 Menomonee Ave",
"city": "Menomonee Falls",
"state": "WI",
"country_code": "US",
"postal_code": "530512810",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.