NPIMap

Amita Atul Butala, M.D.

Individual provider Active NPI Internal Medicine Physician · Rome, NY

NPI 1720184948 · NPPES record last updated Jul 20, 2022

Key facts

NPI
1720184948
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
187464 (NY)
Practice address
1617 N James St Ste 900
Rome, NY 13440-2846
Phone
(315) 336-8260
Fax
(315) 314-8536
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

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

Medicare Care Compare profile

Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS Inc (330 clinicians)

Practice addresses (Care Compare)

1617 N James St
Rome, NY 13440-2852
Phone (315) 336-8260

Hospital & facility affiliations

  • Vna Utica and Oneida Co Chha Home health agency · Utica, NY · CCN 337078
  • Wynn Hospital Hospital · Utica, NY · CCN 330044
  • Rome Memorial Hospital, Inc Hospital · Rome, NY · CCN 330215
  • University Hospital S U N Y Health Science Center Hospital · Syracuse, NY · CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100 (group)
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070828000925 NY Practitioner - Internal Medicine 1355441403 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Medical, P.C. Internal Medicine Current
since Jul 18, 2006		 Accepting new patients
MVHS Inc Current
since Aug 1, 2022		 Accepting new patients
MVHS Inc Current
since Aug 1, 2022		 Accepting new patients

Locations

175 W Main St
Little Falls, NY 13365
Phone (315) 823-0351

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1107 Floyd Ave
Rome, NY 13440
Phone (315) 339-1432

1617 N James St
Rome, NY 13440
Phone (315) 336-8260

1617 N James St
Ste 900
Rome, NY 13440
Phone (315) 336-7499

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: abutala36874@mvhealthsystem.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 187464 NY Yes

Addresses

Primary practice location

1617 N James St Ste 900
Rome, NY 13440-2846

Mailing address

2209 Genesee St
Utica, NY 13501-5999
Phone (315) 801-8534

Other identifiers

IdentifierTypeStateIssuer
01382732MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 20, 2022.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1720184948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015999",
            "telephone_number": "315-801-8534",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N JAMES ST STE 900",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402846",
            "telephone_number": "315-336-8260",
            "fax_number": "315-314-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTALA",
        "first_name": "AMITA",
        "middle_name": "ATUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "187464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01382732",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

All providers in Rome, NY · Internal Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.