Holly Beth Mutton, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

237003 Issued in NY

Practice address

462 Grider St, Ecmc, Room 1168
Buffalo, NY 14215-3021

Phone

(716) 898-4535

Fax

(716) 898-4538

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• University Psychiatric Practice, Inc

  • Psychiatry Physician
  • Buffalo, NY
  • NPI 1588743702
  NPD
• Suburban Psychiatric Associates, LLP

  • Psychiatry Physician
  • Amherst, NY
  • NPI 1851331367
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1962431601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OLD MEADOW DR",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512402",
            "telephone_number": "716-689-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST, ECMC, ROOM 1168",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4535",
            "fax_number": "716-898-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTON",
        "first_name": "HOLLY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "237003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bilal Mustafa, MD
• Esra Mustafa, PHARMD
• Nina Mustico
• Vasanthan Muthusamy Kumarasamy, MBBS
• Amanda Rose Mutka, PHARMD
• Christopher Edward Mutty, M.D.
• Maarya Muzzammil, MD
• Jean - Charles Mwibanire
• Myron Mychajluk, CASAC
• David E Myers, MD

• Psychiatry Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.