Individual provider Active NPI

Mason Trevor Callahan

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1053104406
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0039360 Issued in OH
Practice address
3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone
(513) 584-1000
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0039360 OH
Nurse Practitioner 363L00000X APRN.CNP.0039360 OH Primary

Addresses

Primary practice location

3188 Bellevue Ave
Cincinnati, OH 45219-2369

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-6200

Other practice location 1

7700 University Dr
West Chester, OH 45069-2505
Phone (513) 475-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922002601 OH Practitioner - Nurse Practitioner 7719481795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Nurse Practitioner CurrentSince Sep 2, 2025 Accepting new patients
University of Cincinnati Medical Center, LLC Nurse Practitioner Current Accepting new patients
University Surgical-Dental Associates, LLC Past Accepting new patients

Locations

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

7675 Wellness Way
West Chester, OH 45069
Phone (513) 475-7400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1053104406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-6200",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 BELLEVUE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192369",
            "telephone_number": "513-584-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 University Dr",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450692505",
            "country_code": "US",
            "telephone_number": "513-475-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MASON",
        "middle_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0039360",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0039360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.