BENJAMIN BUTLER MD
NPI 1245624279
Internal Medicine - Pulmonary Disease in Athens, GA

Active since March 27, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
3320 OLD JEFFERSON RD STE 200A, ATHENS, GA 30607(706) 549-5560(706) 543-2593 Get Directions Write a Review

NPPES record last updated: August 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 8, 2022, Jul 18, 2018 (2 updates tracked since 2018).

About Benjamin Butler Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN BUTLER MD (NPI 1245624279) is an individual pulmonary disease provider in Athens, Georgia, licensed in Georgia (92980) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and maintains a secondary practice location in Montgomery.

NPPES Registry Identity

NPI1245624279
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameBENJAMIN BUTLERCredential: MD
Location Address3320 OLD JEFFERSON RD STE 200AAthens, GA 30607-1478
Mailing Address3320 Old Jefferson Rd Ste 200aAthens, GA 30607-1478 · (706) 549-5560
Fax(706) 543-2593
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2015
Enumeration DateMarch 27, 2015
Last NPPES UpdateAugust 8, 20222 updates tracked since enumeration
NPPES CertifiedAugust 8, 2022
NPI 1245624279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in GA · 92980
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD.36493 (AL)
3320 OLD JEFFERSON RD STE 200A, Athens, GA 30607

Secondary Practice Location 1

Location 12055 E South Blvd Ste 202Montgomery, AL 36116 · Phone (334) 284-5211 · Fax (334) 284-5216

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Benjamin Butler Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42520421
PECOS Enrollment IDI20220815002934
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
255 services110 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
176 services83 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
173 services119 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
136 services134 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
122 services119 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
97 services79 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Hospital

Acute Care Hospitals · Athens, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110006
Location1230 Baxter StreetAthens, GA 30606 · Clarke County
Emergency services Birthing friendly

Ty Cobb Regional Medical Center, LLC

Acute Care Hospitals · Lavonia, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110027
Location367 Clear Creek ParkwayLavonia, GA 30553 · Franklin County
Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110046
Location2151 W Spring StreetMonroe, GA 30655 · Walton County
Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110074
Location1199 Prince AvenueAthens, GA 30606 · Clarke County
Birthing friendly

St. Mary's Good Samaritan Hospital

Critical Access Hospitals · Greensboro, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number111329
Location5401 Lake Oconee ParkwayGreensboro, GA 30642 · Greene County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30607 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers20 claims20 services$7.40 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers39 claims40 services$95.18 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers11 claims12 services$33.93 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$31.90 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Acute Care)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Internal Medicine (Sleep Medicine)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Internal Medicine (Pulmonary Disease)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Nurse Practitioner (Acute Care)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Nurse Practitioner (Family)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Nurse Practitioner
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607
Internal Medicine (Pulmonary Disease)
3320 OLD JEFFERSON RD STE 200A
ATHENS, GA 30607

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 Benjamin Butler's NPI number?

The NPI number for Benjamin Butler is 1245624279. It was assigned to this individual provider in the NPPES registry on March 27, 2015.

Where is Benjamin Butler located?

Benjamin Butler practices at 3320 Old Jefferson Rd Ste 200A, Athens, GA 30607. The listed phone number is (706) 549-5560.

What is Benjamin Butler's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Benjamin Butler enrolled in Medicare?

Yes. Benjamin Butler is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Benjamin Butler accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Benjamin 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.

Is Benjamin Butler affiliated with any hospitals?

According to CMS data, Benjamin Butler is affiliated with St Mary's Hospital, Ty Cobb Regional Medical Center, LLC, Piedmont Walton Hospital, Piedmont Athens Regional Medical Center and St. Mary's Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Butler was last updated on August 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.