NPIMap

Individual provider Active NPI

Wesley Wing Wah Butt, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1710521208
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C174258 Issued in CA
Practice address
3801 Filbert St BLDG Suite212
Philadelphia, PA 19104
Phone
(215) 662-8978
NPI assigned
Oct 29, 2019
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C174258 CA Primary
Family Medicine Physician 207Q00000X MD16837 RI

Addresses

Primary practice location

3801 Filbert St BLDG Suite212
Philadelphia, PA 19104

Mailing address

3801 Filbert St BLDG Suite212
Philadelphia, PA 19104
Phone (215) 662-8978

Other practice location 1

355 Prairie Ave
Providence, RI 02905-1928
Phone (401) 444-0570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wesley.butt@providencechc.directbygreenway.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621000911 PA Practitioner - Family Practice 6305279720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3801 Filbert St 212 Medical Arts
Presby Internal Med
Philadelphia, PA 19104-2640
Phone (215) 662-8978

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C174258CAMDFamily Medicine Physician
MD16837RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 1, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Aug 1, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients

Locations

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1710521208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST BLDG SUITE212",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST BLDG SUITE212",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029051928",
            "country_code": "US",
            "telephone_number": "401-444-0570",
            "fax_number": "401-444-0427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTT",
        "first_name": "WESLEY",
        "middle_name": "WING WAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C174258",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD16837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wesley.butt@providencechc.directbygreenway.com",
            "affiliation": "N",
            "address_1": "355 Prairie Ave",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029051928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.