Doctor profile · Federal record
Dr. Dominique Butawan-Ali, MD
Obstetrics & Gynecology Physician (CMS: Obstetrics/Gynecology) · Obstetrics & Gynecology Physician · Obstetrics & Gynecology Physician · Memphis, TN
- NPI 1417121013
- Accepts Medicare
- 14 yrs in practice
- Licensed in 3 states
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
6215 Humphreys Blvd Ste 100, Mid South OB-GYN PLLC
Memphis, TN 38120
(901) 747-1200
fax (901) 747-1220
Credentials & registration
- NPI registered
- April 2008 — 18 yrs on file
- Profile last updated
- October 16, 2025
- Year of graduation
- 2012 — 14 yrs since
- Specialty taxonomy
- 207V00000X — NUCC code
- State licenses (3)
- Tennessee #54889 · Arkansas #E-8519 · North Carolina #201200884
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1417121013. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
62
Distinct HCPCS
3
Medicare allowed
$1,440
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination | 26 | 26 | $35 | |
81002 |
Urinalysis, manual test | 25 | 25 | $3 | |
Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 11 | 11 | $39 |
In context: peer comparison
Among 19 peers in Memphis Obstetrics & Gynecology Physician, average services per provider: 40. This provider delivers 1.6× the peer median.Open Payments
Industry payments received
All-time total
$925
Transactions
43
Manufacturers
15
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Shield Therapeutics INC | 11 | $170.91 | |
| Biogen, INC. | 7 | $142.79 | |
| Millicent US INC | 3 | $132.63 | |
| Astellas Pharma US INC | 4 | $97.72 | |
| Pfizer INC. | 3 | $44.70 | |
| Organon LLC | 2 | $40.08 | |
| Exeltis, USA INC. | 2 | $38.59 | |
| Novo Nordisk INC | 2 | $37.47 | |
| Hologic Sales and Service, LLC | 2 | $36.24 | |
| Monaghan Medical Corporation | 1 | $30.55 | |
| Pacira Pharmaceuticals Incorporated | 1 | $28.76 | |
| Mayne Pharma Commercial LLC | 2 | $27.99 | |
| Seqirus USA INC | 1 | $24.94 | |
| Northgate Technologies, INC. | 1 | $22.35 | |
| Bayer Healthcare Pharmaceuticals INC. | 1 | $18.92 |
By nature of payment
Frequently asked questions
What is Dr. Dominique Butawan-Ali's medical specialty?
Dr. Dominique Butawan-Ali practices Obstetrics & Gynecology Physician in Memphis, TN.
Where does Dr. Dominique Butawan-Ali practice?
Dr. Dominique Butawan-Ali practices at 6215 Humphreys Blvd Ste 100, Memphis, TN 38120. Office phone: 9017471200.
What is Dr. Dominique Butawan-Ali's NPI?
Dr. Dominique Butawan-Ali's National Provider Identifier (NPI) is 1417121013, issued by NPPES.
Does Dr. Dominique Butawan-Ali accept Medicare assignment?
Yes. Dr. Dominique Butawan-Ali accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Dominique Butawan-Ali commonly perform?
Top Medicare-reported procedures in 2023: Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS G0101); Urinalysis, manual test (HCPCS 81002); Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS Q0091). Source: CMS Medicare Physician & Other Practitioners file.