KEISHA MONIQUE BUTLER D.D.S
NPI 1164834628
Dentist - General Practice in Bronx, NY
About Keisha Monique Butler D.d.s NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEISHA MONIQUE BUTLER D.D.S (NPI 1164834628) is an individual general practice provider in Bronx, New York, licensed in New York (058135) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Columbia.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Keisha Monique Butler D.d.s is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Keisha Butler reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bronx, NY 10457
- Reassigned Medicare billing, New York enrollment
- 1,615 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10453 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Keisha Butler's NPI number?
The NPI number for Keisha Butler is 1164834628. It was assigned to this individual provider in the NPPES registry on June 2, 2014.
Where is Keisha Butler located?
Keisha Butler practices at 85 W Burnside Ave, Bronx, NY 10453. The listed phone number is (718) 716-4400.
What is Keisha Butler's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Keisha Butler enrolled in Medicare?
Yes. Keisha Butler is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Keisha Butler's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keisha Butler reassigns Medicare benefits to New York City Health And Hospitals Corporation (Bronx, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keisha Butler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Keisha Butler accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, HRI Dental & Vision and Paramount list Keisha Butler as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Keisha Butler was last updated on August 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Keisha Monique Butler, D.D.S · NPI 1164834628
General Practice provider in Bronx, New York. Individual provider, active in the CMS NPPES registry since June 2, 2014.
## Identity
- **NPI:** 1164834628 (Entity type: Individual)
- **Enumerated:** June 2, 2014
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 058135 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 85 W BURNSIDE AVE, Bronx, NY 10453-4015
- **Phone:** (718) 716-4400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** New York City Health And Hospitals Corporation (NPI 1548998347, Bronx, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 5, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1164834628) · Data from the CMS NPPES public registry.