SYDNEY ANN BUTALLA (OD) – Optometrist, NPI 1639918980

SYDNEY ANN BUTALLA (OD) is a healthcare provider. based in Portland, Maine. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT1088 (ME). The NPI Number for SYDNEY ANN BUTALLA (OD) is 1639918980

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SYDNEY ANN BUTALLA (OD)
NPI
1639918980
Phone
(207) 210-6700
Address
595 Brighton Ave
Enumeration Date
24 May 2024
Last Update Date
11 June 2025

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
2072106700
Graduation Year
2024 (2 years ago)
PAC ID
2668986506
Group Practice PAC ID
0042359515
Professional Enrollment ID
I20250710002938
Address ID
ME041022322PO595XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

219 OPTOMETRY in ME

Provider Addresses for SYDNEY ANN BUTALLA (OD)

  • 595 Brighton Ave

    Portland, ME 041022322

    Phone: (207) 210-6700

    Type: Location

  • 8 ROGERS RD UNIT 207

    FREEPORT, ME 040327506

    Phone: (763) 354-4024

    Type: Mailing

  • 152 MIDDLE ST

    PORTLAND, ME 041014123

    Phone: (207) 775-1819

    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 $44.

Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Tarsus Pharmaceuticals, Inc. ($44).

Total Amount

$44

General + Research + Ownership

Payments

1

Total payment records

General Amount

$44

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

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: 2025-07-10

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
I20250710002938IOptometryMETBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04102)

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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: 0042359515View full group profile
NameSpecialtyState
O P T O M E T R YCT
-ME
O P T O M E T R YME
O P T O M E T R YME

Reviews

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Frequently asked questions

What federal number belongs to SYDNEY ANN BUTALLA (OD)?
The federal identifier for SYDNEY ANN BUTALLA (OD) is NPI 1639918980.
Is SYDNEY ANN BUTALLA (OD) active in the national directory?
SYDNEY ANN BUTALLA (OD)'s public NPI profile is in an active state.
Does SYDNEY ANN BUTALLA (OD) list a primary specialty?
If you are matching referrals, note Optometrist for SYDNEY ANN BUTALLA (OD). Clinical services aligned with this taxonomy classification.
What location metadata exists for SYDNEY ANN BUTALLA (OD)?
The page summarizes Portland, Maine for SYDNEY ANN BUTALLA (OD); expand the address list for detail.
How can I contact SYDNEY ANN BUTALLA (OD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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