Laurie Dasso Butler, PA
Individual provider Active NPI Physician Assistant · Wilbraham, MA
NPI 1669459178 · NPPES record last updated Apr 26, 2017
Key facts
- NPI
- 1669459178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 888 (MA)
- Practice address
- 2344 Boston Rd
Wilbraham, MA 01095-1104 - Phone
- (413) 596-5550
- Fax
- (413) 794-2551
- NPI assigned
- Dec 27, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 888 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baystate Affiliated Practice Organization | Past | Accepting new patients | |
| Accountable Care Practice Services PC | Past |
Accepting new patients | |
| Accountable Care Clinical Services PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 888 | MA | Yes |
Addresses
Primary practice location
2344 Boston Rd
Wilbraham, MA 01095-1104
Mailing address
280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700
Other providers in Wilbraham, MA
- Tyler Joseph Branco
- Adriana Brooks
- Lisa Beth Brosnan
- Lindsey Brunette
- Amanda M Bryant
- Celsea Caisse
- Molly Caltabiano
- Daniel Cardinal
- Alyssa Marie Charbonneau
- Dusty Marie Charbonneau
All providers in Wilbraham, MA · Physician Assistant in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.