Individual provider Active NPI

Michael James Butera, CRNA

  • Certified Registered Nurse Anesthetist
  • W Roxbury, MA
National Provider Identifier
1710077276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA169000 Issued in MA
Practice address
1400 VFW Parkway
W. Roxbury, MA 02132
Phone
(617) 323-7700
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA169000 MA Primary

Addresses

Primary practice location

1400 VFW Parkway
W. Roxbury, MA 02132

Mailing address

23 Rideout LN
Stoughton, MA 02072-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000191 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688651961 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JJM Medical Services PCGroup PAC ID 6800950312, 36 clinicians
Massachusetts Anesthesiology Associates PCGroup PAC ID 9931348232, 5 clinicians

Practice addresses (Care Compare)

1440 Main St
Waltham, MA 02451-1631
Phone (781) 891-9300

333 Elm St
Dedham, MA 02026-4530
Phone (781) 326-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA169000MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 30, 2018 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 30, 2018 Accepting new patients
JJM Medical Services, PC CurrentSince May 15, 2024 Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

333 Elm St
Dedham, MA 02026
Phone (781) 214-6590

145 West St
Milford, MA 01757
Phone (508) 381-5600

907 Sumner St
#M201
Stoughton, MA 02072
Phone (781) 923-6434

907 Sumner St
Ste M201
Stoughton, MA 02072

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

5 Johnson Rd
Latham, NY 12110
Phone (518) 767-0869

Organizations & group practices 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710077276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 RIDEOUT LN",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PARKWAY",
            "city": "W. ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "617-323-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERA",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "NA169000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.