Individual provider Active NPI

Samantha Butzke, MD

  • Pediatric Gastroenterology Physician
  • Annapolis, MD
National Provider Identifier
1780114967
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
D0093369 Issued in MD
Practice address
621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone
(410) 224-4887
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Gastroenterology Physician 2080P0206X D0093369 MD Primary

Addresses

Primary practice location

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083

Mailing address

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone (410) 224-4887

Other identifiers 1

IdentifierTypeStateIssuer
390200000XOtherSTUDENT, HEALTH CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220907003524 MD Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0840674032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Digestive Associates, PCGroup PAC ID 5597151357, 38 clinicians

Practice addresses (Care Compare)

621 Ridgely Ave
Suite 201
Annapolis, MD 21401-1083
Phone 4102244887421

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
59.44
Promoting interoperability
97
Improvement activities
40
Cost
81.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093369MDMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Digestive Associates, PC CurrentSince Sep 1, 2022 Accepting new patients
Galloway Anesthesia Associates LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

621 Ridgely Ave
Ste 201
Annapolis, MD 21401
Phone (410) 224-4887

Interoperability endpoints

  • Direct secure messaging: samantha.butzke@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1780114967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTZKE",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MD",
            "license": "D0093369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT, HEALTH CARE",
            "identifier": "390200000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.