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ELISSA KATHLEEN BUTLER MD, MPH
NPI 1699160242
Surgery - Pediatric Surgery in Minneapolis, MN

Active since March 31, 2015PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 365-1000 Get Directions Write a Review

NPPES record last updated: August 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 9, 2024, Mar 31, 2017 (2 updates tracked since 2017).

About Elissa Kathleen Butler Md, Mph NPPES

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

ELISSA KATHLEEN BUTLER MD, MPH (NPI 1699160242) is an individual pediatric surgery provider in Minneapolis, Minnesota, licensed in Minnesota (77646) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699160242
Entity TypeIndividualFemale
Primary Taxonomy2086S0120X
Provider Legal NameELISSA KATHLEEN BUTLERCredential: MD, MPH
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address319 15th Ave SeMinneapolis, MN 55455-0118 · (800) 756-2363
Phone(612) 365-1000
Sole ProprietorNo
Enumeration DateMarch 31, 2015
Last NPPES UpdateAugust 9, 20242 updates tracked since enumeration
NPPES CertifiedAugust 9, 2024
✔ NPI 1699160242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in MN · 77646
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elissa Kathleen Butler Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

5

Medicare enrollment records show Elissa Butler reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
Same address
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Specialty Services
Same address
Physical Therapy
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,373 clinicians in this Medicare group
NPI 1043199334 (855) 324-7843
University Of Minnesota Pediatric Dental Clinic
0.1 mi
Dentist
701 25TH AVE S, SUITE 400
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: University Of Minnesota Physicians
  • 1,453 clinicians in this Medicare group
NPI 1992075287 (651) 659-4900
University Of Minnesota Health Clinics And Surgery Center Inc
0.7 mi
Anesthesiology
909 FULTON ST SE
Minneapolis, MN 55455
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,662 clinicians in this Medicare group
NPI 1003485004 (612) 273-8383
Hennepin Healthcare System, Inc
1.2 mi
Home Health
825 S 8TH ST, SL10
Minneapolis, MN 55404
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,247 clinicians in this Medicare group
NPI 1962914333 (612) 617-4600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Elissa Butler's NPI number?

The NPI number for Elissa Butler is 1699160242. It was assigned to this individual provider in the NPPES registry on March 31, 2015.

Where is Elissa Butler located?

Elissa Butler practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 365-1000.

What is Elissa Butler's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Elissa Butler enrolled in Medicare?

Yes. Elissa Butler is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Elissa Butler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elissa Butler reassigns Medicare benefits to 5 organizations: Fairview Express Care (Minneapolis, MN), Fairview Specialty Services (Minneapolis, MN), University Of Minnesota Pediatric Dental Clinic (Minneapolis, MN), University Of Minnesota Health Clinics And Surgery Center Inc (Minneapolis, MN) and Hennepin Healthcare System, Inc (Minneapolis, MN). Each 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 Elissa Butler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elissa Butler accept?

Health plans from HealthPartners and Sanford Health Plan list Elissa 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 Elissa Butler was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.