Individual provider Active NPI

Michael Edward Kallen, M.D.

  • Hematology (Pathology) Physician
  • Baltimore, MD
National Provider Identifier
1013207182
Registry record updated Dec 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Pathology) PhysicianTaxonomy code 207ZH0000X
License
D83267 Issued in MD
Practice address
401 N Broadway St
Baltimore, MD 21287-0019
Phone
(410) 955-3580
Fax
(410) 614-1287
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X D83267 MD Primary

Addresses

Primary practice location

401 N Broadway St
Baltimore, MD 21287-0019

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-6423

Other practice location 1

24507 Starlight Ln
West Hills, CA 91307-3833
Phone (818) 307-4962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170810002110 MD Practitioner - PathologyPractitioner - Hematology 3173894029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology
Education
Vanderbilt University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5555

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Univ of MD Pathology Associates P a CurrentSince Aug 21, 2018 Accepting new patients
Chester River Hospital Center CurrentSince Oct 1, 2024 Accepting new patients
Univ of MD Pathology Associates P a Current Accepting new patients
Chester River Health Center CurrentSince Oct 1, 2024 Accepting new patients

Locations

419 W Redwood St
Ste 200
Baltimore, MD 21201
Phone (410) 328-3408

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

100 Brown St
Chestertown, MD 21620
Phone (410) 778-3300

219 S Washington St
Easton, MD 21601

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544832000000",
    "number": "1013207182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019",
            "telephone_number": "410-955-3580",
            "fax_number": "410-614-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24507 Starlight Ln",
            "address_purpose": "LOCATION",
            "city": "West Hills",
            "state": "CA",
            "postal_code": "913073833",
            "country_code": "US",
            "telephone_number": "818-307-4962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLEN",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2018-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "MD",
            "license": "D83267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.