Individual provider Active NPI

Caroline Wheeler Butts, PA-S

  • Physician Assistant
  • Wauwatosa, WI
National Provider Identifier
1912630641
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7945-23 Issued in WI
Practice address
10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315
Phone
(414) 877-5350
NPI assigned
Jul 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7945-23 WI Primary

Addresses

Primary practice location

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315

Mailing address

N91W16015 Junction Way Apt 301
Menomonee Falls, WI 53051-3160
Phone (910) 635-6929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7945-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
EMS Observation, S.C. CurrentSince Jun 16, 2024 Accepting new patients
Shoreview Pediatrics, S.C. PastSince Jul 1, 2022 Accepting new patients

Locations

10625 W North Ave
Ste 101B
Wauwatosa, WI 53226
Phone (414) 727-9183

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71671

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": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1912630641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N91W16015 JUNCTION WAY APT 301",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513160",
            "telephone_number": "910-635-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 101B",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "CAROLINE",
        "middle_name": "WHEELER",
        "name_prefix": "Mrs.",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-09",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7945-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.