Paul Devine Bottone, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MT219847 Issued in PA

Practice address

3401 Civic Center Blvd
Division of Adolescent Medicine
Philadelphia, PA 19104

Phone

(215) 590-1190

Fax

(215) 590-4668

NPI assigned

Jun 11, 2013

Last updated

Aug 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Childen's Health Care Associates Inc.

  dba CHCA Nurse Practitioners

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Childrens Health Care Associates, Inc

  dba CHCA Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Philadelphia, PA
  • NPI 1548355597
  NPD
• Childrens Hospital of Philadelphia

  • Children's Hospital
  • Philadelphia, PA
  • NPI 1215921457
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1659719748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE M975",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF ADOLESCENT MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-1190",
            "fax_number": "215-590-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTONE",
        "first_name": "PAUL",
        "middle_name": "DEVINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.140820",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MT219847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bosworth, RD, LDN
• Denise Botcheos
• Katherine Deharte Botta, MD
• Katelyn Bottcher
• Bryan Andrew Botti, M.D.
• Alexander Botwick, D.M.D.
• Benchaa Boualam, MD
• Hadi Bouali
• Alixandra Boucher
• Noelle Elizabeth Boucher, PA-C

• Pediatric Adolescent Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Adolescent Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.

Verify at the official NPI Registry.