Individual provider Active NPI

Desiree Beth Butter, M.D.

  • Family Medicine Physician
  • Wexford, PA
National Provider Identifier
1780646539
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-060804-L Issued in PA
Practice address
101 Bradford Rd
Stonewood Commons I Suite 220
Wexford, PA 15090-6909
Phone
(724) 940-5555
Fax
(724) 940-5556
NPI assigned
Apr 6, 2006
Last updated
Feb 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-060804-L PA Primary

Addresses

Primary practice location

101 Bradford Rd
Stonewood Commons I Suite 220
Wexford, PA 15090-6909

Mailing address

101 Bradford Rd
Stonewood Commons I Suite 220
Wexford, PA 15090-6909
Phone (724) 940-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040623000048 PA Practitioner - Family Practice 2769467810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pittsburgh School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Bradford Rd
Suite 220
Wexford, PA 15090-6925
Phone (724) 940-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-060804-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colonnades Family Medicine LLC Family Medicine CurrentSince Mar 1, 2004 Accepting new patients
Mercy Primary Care, Inc Past Accepting new patients

Locations

101 Bradford Rd
Ste 220
Wexford, PA 15090
Phone (412) 583-7411

Organizations & group practices 2

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 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1780646539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BRADFORD RD",
            "address_2": "STONEWOOD COMMONS I SUITE 220",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906909",
            "telephone_number": "724-940-5555",
            "fax_number": "724-940-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRADFORD RD",
            "address_2": "STONEWOOD COMMONS I SUITE 220",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906909",
            "telephone_number": "724-940-5555",
            "fax_number": "724-940-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTER",
        "first_name": "DESIREE",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-060804-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.