NPIMap

Organization Active NPI

Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
National Provider Identifier
1013220151
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
STEWARD MEDICAL GROUP, INC
Practice address
77 Warren St
Brighton, MA 02135-3601
Phone
(615) 467-4158
Fax
(615) 467-1267
NPI assigned
Jul 19, 2010
Organization subpart
Yes
Parent organization
STEWARD HEALTH CARE SYSTEM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Michael J Callum, MD
Title
Ceo of Steward Physician Network
Phone
(615) 467-4158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

77 Warren St
Brighton, MA 02135-3601

Mailing address

9 Galen St
Watertown, MA 02472-4515
Phone (615) 467-4158

Other names 1

  • Steward Physician Network - Pathology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101118000660 MA Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 26 practitioners
1 other NPI on this enrollment
Practice locations: Ayer, MA; Taunton, MA; Stoughton, MA; Norwood, MA; Methuen, MA; Haverhill, MA; Fall River, MA; Dorchester, MA…
O20170524000169 PA Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 179 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hermitage, PA; Easton, PA; Holland, PA; Meadville, PA; Mercer, PA; New Castle, PA; Sharon, PA; Wind Gap, PA…

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Compass Medical PC60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

2395 Garden Way
Sharon, PA 16148
Phone (724) 342-5890

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1013220151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GALEN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724515",
            "telephone_number": "615-467-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "615-467-4158",
            "fax_number": "615-467-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWARD MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEWARD HEALTH CARE SYSTEM LLC",
        "enumeration_date": "2010-07-19",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "CALLUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO OF STEWARD PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "615-467-4158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steward Physician Network - Pathology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Steward Physician Network - Pathology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.