NPIMap

Individual provider Active NPI

Brian Thomas Callahan, M.D.

  • Diagnostic Radiology Physician
  • Lackland AFB, TX
National Provider Identifier
1013059625
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
226167 Issued in MA
Practice address
2200 Bergquist Dr
Lackland a F B, TX 78236-9907
Phone
(210) 292-2205
NPI assigned
Feb 12, 2007
Last updated
Sep 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 226167 MA Primary
Vascular & Interventional Radiology Physician 2085R0204X 233866 MA

Addresses

Primary practice location

2200 Bergquist Dr
Lackland a F B, TX 78236-9907

Mailing address

5 Myrtlewood
San Antonio, TX 78218-6000
Phone (617) 595-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181107001724 MD Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7113183807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Harvard Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.26 of 100Reported as group
Quality
81.56
Promoting interoperability
100
Improvement activities
40
Cost
69.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
226167MAMDDiagnostic Radiology Physician
233866MAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Health System, Inc CurrentSince Sep 1, 2024 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 3, 2023 Accepting new patients
Shore Health System, Inc CurrentSince Dec 7, 2018 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 3, 2023 Accepting new patients
Delmarva Radiology P.a. Diagnostic Radiology CurrentSince Sep 28, 2018 Accepting new patients
Shore Health System, Inc CurrentSince Aug 31, 2021 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

918 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 749-1123

Interoperability endpoints

  • Direct secure messaging: bcallahan550093@direct.umm.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1013059625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MYRTLEWOOD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782186000",
            "telephone_number": "617-595-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "226167",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "233866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.