DANIEL R BUTLER PA-C NPI 1386796365
Physician Assistant - Medical in Mt Pleasant, SC
About DANIEL R BUTLER PA-C
Daniel Butler is a primary care provider established in Mt Pleasant, South Carolina and his medical specialization is Physician Assistant with a focus in medical with more than 16 years of experience. He graduated from Medical University Of South Carolina College Of Medicine in 2008. The NPI number of this provider is 1386796365 and was assigned on January 2007. The practitioner's primary taxonomy code is 363AM0700X with license number 938 (SC). The provider is registered as an individual and his NPI record was last updated March 2023.
| NPI | 1386796365 |
| Provider Name | DANIEL R BUTLER PA-C |
| Location Address | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 |
| Location Phone | (843) 849-1551 |
| Mailing Address | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 2008 |
| Is Sole Proprietor? | No |
| Enumeration Date | 01-18-2007 |
| Last Update Date | 03-30-2023 |
A primary care provider (PCP) like Daniel Butler sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc Daniel Butler is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Daniel Butler is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with East Cooper Medical Center.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 60, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 363AM0700X |
| Classification | Physician Assistant |
| Type | Physician Assistants & Advanced Practice Nursing Providers |
| Specialization | Medical |
| License No. | 938 |
| License State | SC |
Business Address
1625 HOSPITAL DR STE 200
MT PLEASANT, SC
ZIP 29464
Phone: (843) 849-1551
Mailing Address
1625 HOSPITAL DR STE 200
MT PLEASANT, SC
ZIP 29464
Phone: (843) 849-1551
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9739210220 |
| PECOS Enrollment ID | I20100628000303 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Overall MIPS Quality Performance
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | N/A | |
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The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores. There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey. |
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| Promoting Interoperability (PI) | 25% | N/A | |
|
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores. The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. |
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| Improvement Activities | 15% | N/A | |
|
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. |
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| Cost | 20% | N/A | |
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The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services. Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. |
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| MIPS Final Score | - | 60 | |
| The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment. | |||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 149Insertion of device into intervertebral disc space of spine and fusion of vertebrae (HCPCS:22853)
- 37Partial removal of middle spine bone with release of spinal cord and/or nerves (HCPCS:63047)
- 28Testing for presence of drug (HCPCS:80307)
- 23Partial removal of spine bone with release of spinal cord and/or nerves (HCPCS:63048)
- 20Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments (HCPCS:22842)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Daniel Butler is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| EAST COOPER MEDICAL CENTER | 2000 HOSPITAL DR MOUNT PLEASANT, SC 29464 | (843) 881-0100 | Acute Care Hospitals | 420089 |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 8 | 6 | 7 | 9 | 6 | 3 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 16 | 6 | 14 | 9 | 12 | 3 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 6 + 6 + 1 + 4 + 9 + 1 + 2 + 3 + 1 + 2 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1386796365 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053528752 | RICHARD F. FRISCH JR. M.D. Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1093241911 | DR. MICHAEL MOSIER Individual | Physical Medicine & Rehabilitation | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1093985285 | MR. BASSAM SHAMEL KASSAB D.P.T. Individual | Physical Therapist | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1114188810 | RYAN HARRISON NOBLES M.D. Individual | Pain Medicine (Interventional Pain Medicine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1194015156 | KIRSTEN DAWSON PA-C Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1275609489 | DR. THOMAS SHANNON ANDERSON MD Individual | Neurological Surgery | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1316151392 | SUZANNE LIVENGOOD BRITT PA-C, MPAS Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1417009499 | JUSTIN SWAIN PA-C Individual | Physician Assistant (Medical) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1437267473 | MARK D NETHERTON MD Individual | Pain Medicine (Interventional Pain Medicine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1497300099 | BLAIRE HOWELL PA-C Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1497423768 | CAITLIN VEREEN Individual | Physical Therapist | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1508841859 | STEVEN C POLETTI M.D. Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1619519360 | ANNA KATHERINE GUITTON PA-C Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1639117807 | MR. GERMAN LEVIN MD Individual | Physical Medicine & Rehabilitation | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1750711701 | MEGHAN NIX PA-C Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1760534358 | SOUTHEASTERN SPINE INSTITUTE,LLC Organization | Clinic/Center (Multi-Specialty) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1790197820 | CAITLIN TUGGLE PA-C Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1841589538 | DR. TIMOTHY W BRYAN MD Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1861802126 | BENJAMIN ALEXANDER SCHELL MD Individual | Orthopaedic Surgery (Orthopaedic Surgery of the Spine) | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
| 1912143819 | AMANDA THURBER HARRIDGE Individual | Physician Assistant | 1625 HOSPITAL DR STE 200 MT PLEASANT, SC 29464 (843) 849-1551 |
Frequently Asked Questions
What is Daniel Butler PA-C NPI number?
The NPI number assigned to this healthcare provider is 1386796365, registered as an "individual" on January 18, 2007
Where is Daniel Butler PA-C located?
The provider is located at 1625 Hospital Dr Ste 200 Mt Pleasant, Sc 29464 and the phone number is (843) 849-1551
Which is Daniel Butler PA-C specialty?
The provider's speciality is Physician Assistant with a focus in Medical
How many years of experience does Daniel Butler PA-C have?
The provider has more than 16 years of experience. He graduated from Medical University Of South Carolina College Of Medicine in 2008.
Is Daniel Butler PA-C registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are some of the services provided by Daniel Butler PA-C?
The most common procedures or services performed by this practitioner are: Insertion of device into intervertebral disc space of spine and fusion of vertebrae, Partial removal of middle spine bone with release of spinal cord and/or nerves, Testing for presence of drug, Partial removal of spine bone with release of spinal cord and/or nerves and Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments.
Is Daniel Butler PA-C affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: EAST COOPER MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Daniel Butler PA-C was last updated on January 18, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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