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Individual provider Active NPI

Shawn T. Butela, M.D.

  • Diagnostic Radiology Physician
  • Norfolk, VA
National Provider Identifier
1891734372
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A71143 Issued in CA
Practice address
110 Kingsley LN
Suite 305
Norfolk, VA 23505-4614
Phone
(757) 889-5942
Fax
(757) 889-5422
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A71143 CA Primary

Addresses

Primary practice location

110 Kingsley LN
Suite 305
Norfolk, VA 23505-4614

Mailing address

110 Kingsley LN
Suite 305
Norfolk, VA 23505-4614
Phone (757) 889-5942

Other identifiers 2

IdentifierTypeStateIssuer
00A711430MedicaidCA
00A711430OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120201000042 VA Practitioner - Diagnostic Radiology 9234175100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Pittsburgh School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hampton Roads Radiology Associates, PCGroup PAC ID 4880688506, 39 clinicians

Practice addresses (Care Compare)

582 Lynnhaven Pkwy
Suite 301
Virginia Beach, VA 23452-7386
Phone (757) 916-9630

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71143CAMDPharmacist
A71143CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsley Lane Anatomic Pathology Current Accepting new patients
Hampton Roads Radiology Associates, PC Diagnostic Radiology CurrentSince Jan 1, 2012 Accepting new patients
South Valley Radiology Medical Group Inc Diagnostic Radiology Past Accepting new patients
Encino Hospital Radiology Medical Group Inc Diagnostic Radiology Past Accepting new patients
SVR Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

582 Lynnhaven Pkwy
Ste 301
Virginia Beach, VA 23452
Phone (757) 916-9631

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1891734372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 305",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-889-5942",
            "fax_number": "757-889-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 305",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-889-5942",
            "fax_number": "757-889-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTELA",
        "first_name": "SHAWN",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A71143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A711430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A711430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.