KEANDRE BUTTS (CAA) – Anesthesiologist Assistant, NPI 1902416308

KEANDRE BUTTS (CAA) is a healthcare provider. based in Covington, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials CAA. They hold a License No. 10001 (GA). The NPI Number for KEANDRE BUTTS (CAA) is 1902416308

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
KEANDRE BUTTS (CAA)
NPI
1902416308
Phone
Not provided
Address
45 LONG CREEK DR
Enumeration Date
31 July 2020
Last Update Date
9 August 2022

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4047787525
Graduation Year
2020 (6 years ago)
PAC ID
7315357464
Group Practice PAC ID
8820901408
Professional Enrollment ID
I20201102000926
Address ID
GA303221013AT1365XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

Provider Addresses for KEANDRE BUTTS (CAA)

  • 45 LONG CREEK DR

    COVINGTON, GA 300167725

    Phone:

    Type: Mailing

  • 500 PEACHTREE ST NE

    ATLANTA, GA 303083109

    Phone: (470) 295-5733

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-07-23 • Largest payer in this snapshot: Intercept Pharmaceuticals, Inc. ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-11-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201102000926IAnesthesiology AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00537Anesthesia for procedure to assess heart electrical activity1212$0
View full utilization report →

Insurance plans in this area (ZIP 30016)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820901408View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineCA
Internal MedicineGA
Physician AssistantFL
Interventional Radiology, Diagnostic RadiologyKY
Anesthesiology AssistantGA
-CA
D E R M A T O L O G YGA
Interventional Radiology, Diagnostic RadiologyNC
Physician AssistantGA
-GA

Reviews

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Frequently asked questions

Can I use this page to confirm KEANDRE BUTTS (CAA)'s NPI?
Yes. KEANDRE BUTTS (CAA) is listed with NPI 1902416308 in the public NPI dataset.
Does CMS list KEANDRE BUTTS (CAA) as active?
Yes — KEANDRE BUTTS (CAA) is active in the NPI listing used on this page.
What taxonomy line describes KEANDRE BUTTS (CAA)?
For research purposes, treat KEANDRE BUTTS (CAA) as Anesthesiologist Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect KEANDRE BUTTS (CAA) on a map?
Expect Covington, Georgia as a primary anchor for KEANDRE BUTTS (CAA) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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