Individual provider Active NPI

Paul Raymond Butzine, MD

  • Psychiatry Physician
  • Sun City West, AZ
National Provider Identifier
1669488912
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
8694 Issued in AZ
Practice address
14506 W Granite Valley Dr
Ste 221
Sun City West, AZ 85375-6010
Phone
(623) 214-1141
Fax
(623) 214-8903
NPI assigned
Jul 31, 2006
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 8694 AZ Primary

Addresses

Primary practice location

14506 W Granite Valley Dr
Ste 221
Sun City West, AZ 85375-6010

Mailing address

14506 W Granite Valley Dr
Ste 221
Sun City West, AZ 85375-6010
Phone (623) 214-1141

Other identifiers 1

IdentifierTypeStateIssuer
260027113OtherAZRRMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8694AZMDPsychiatry Physician

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, 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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1669488912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14506 W GRANITE VALLEY DR",
            "address_2": "STE 221",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756010",
            "telephone_number": "623-214-1141",
            "fax_number": "623-214-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14506 W GRANITE VALLEY DR",
            "address_2": "STE 221",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756010",
            "telephone_number": "623-214-1141",
            "fax_number": "623-214-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTZINE",
        "first_name": "PAUL",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "8694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMED",
            "identifier": "260027113",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.