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DR. ATUL V BUTALA MD FACP
NPI 1619936127
Internal Medicine - Hematology & Oncology in Utica, NY

Active since March 22, 2006PECOS EnrolledAccepts Medicare Assignment
78.7/100
CMS Quality Rating
807 NEWELL STREET, UTICA, NY 13502(315) 798-9300(315) 793-8320 Get Directions Write a Review

NPPES record last updated: October 24, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Atul V Butala Md Facp NPPES

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

DR. ATUL V BUTALA MD FACP (NPI 1619936127) is an individual hematology & oncology provider in Utica, New York, licensed in New York (157450) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1619936127
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. ATUL V BUTALACredential: MD FACP
Location Address807 NEWELL STREETUtica, NY 13502
Mailing Address807 Newell StreetUtica, NY 13502 · (315) 798-9300 · Fax (315) 793-8320
Phone(315) 798-9300
Fax(315) 793-8320
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateMarch 22, 2006
Last NPPES UpdateOctober 24, 2008
✔ NPI 1619936127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in NY · 157450
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License 157450 (NY)
807 NEWELL STREET, Utica, NY 13502
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Other Identifiers 3

Medicare UPINA64753
Medicare ID-Type Unspecified55641ANY
Medicaid00997719NY

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

Dr. Atul V Butala Md Facp 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 ID345148425
PECOS Enrollment IDI20110120001238
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 11

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.

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.
492 services186 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.
252 services60 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
173 services54 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.
164 services99 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
75 services58 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
33 services24 patients

Hospital Affiliations CMS Care Compare 3

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

Wynn Hospital

Acute Care Hospitals · Utica, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330044
Location111 Hospital DriveUtica, NY 13502 · Oneida County
Emergency services Birthing friendly

Rome Memorial Hospital, Inc

Acute Care Hospitals · Rome, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330215
Location1500 North James StreetRome, NY 13440 · Oneida County
Emergency services Birthing friendly

Lewis County General Hospital

Critical Access Hospitals · Lowville, NY
OwnershipGovernment - Local
CMS Certification Number331317
Location7785 North State StreetLowville, NY 13367 · Lewis County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13502 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
$166.88 typical visit price
range $54.87 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

78.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.73
Promoting Interoperability99
Improvement Activities40
Cost42.38

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
32%409 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,522 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
62%638 patients3/55-star benchmark: 100%
Hematology: Myelodysplastic Syndrome (MDS) and Acute Leukemias: Baseline Cytogenetic Testing Performed on Bone Marrow
Percentage of patients aged 18 years and older with a diagnosis of myelodysplastic syndrome (MDS) or an acute leukemia who had baseline cytogenetic testing performed on bone marrow
4%26 patients
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%146 patients5/55-star benchmark: 100%
Oncology: Medical and Radiation - Pain Intensity Quantified
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified
100%763 patients5/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
100%2,103 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%812 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 479 patients
Patients tobacco: 73% · 114 patients
94%479 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
1%812 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%812 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 2% · 425 patients
12%425 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
1 supplier12 claims180 services$4.93 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
1 supplier12 claims77 services$8.49 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
1 supplier12 claims78 services$3.48 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

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

ATUL BUTALA PHYSICIAN PC
Internal Medicine (Hematology & Oncology)
807 NEWELL STREET
UTICA, NY 13502
Oneida County (315) 798-9300

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 Atul Butala's NPI number?

The NPI number for Atul Butala is 1619936127. It was assigned to this individual provider in the NPPES registry on March 22, 2006.

Where is Atul Butala located?

Atul Butala practices at 807 Newell Street, Utica, NY 13502. The listed phone number is (315) 798-9300.

What is Atul Butala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Atul Butala enrolled in Medicare?

Yes. Atul Butala 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.

Is Atul Butala affiliated with any hospitals?

According to CMS data, Atul Butala is affiliated with Wynn Hospital, Rome Memorial Hospital, Inc and Lewis County General Hospital.

When was this NPI record last updated?

The NPPES record for Atul Butala was last updated on October 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.