Individual provider Active NPI

Benjamin McCallister Jr., MD

  • Cardiovascular Disease Physician
  • Ypsilanti, MI
National Provider Identifier
1053388595
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301058673 Issued in MI
Practice address
5325 Elliott Dr
Suite 203
Ypsilanti, MI 48197-8633
Phone
(734) 712-8000
Fax
(734) 712-4429
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301058673 MI Primary

Addresses

Primary practice location

5325 Elliott Dr
Suite 203
Ypsilanti, MI 48197-8633

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 - Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080527000524 MI Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 1456263029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Vanderbilt University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

14555 Levan Rd
Livonia, MI 48154-5085

14650 E Old US Hwy 12
Chelsea, MI 48118-1801

1600 S Canton Ctr Rd
Canton, MI 48188-1992

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

5325 Elliott Dr
Ypsilanti, MI 48197-8633

620 Byron Rd
Howell, MI 48843-1002

7575 Grand River Rd
Brighton, MI 48114-9309
Phone (734) 712-7255

7575 Grand River Rd
Brighton, MI 48114-9379

775 S Main St
Chelsea, MI 48118-1383

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Organization Cardiovascular Disease CurrentSince Jun 15, 2014 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Jun 15, 2014 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

14555 Levan Rd
Ste 203
Livonia, MI 48154
Phone (734) 462-3233

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ypsilanti, MI 48197

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

Interoperability endpoints

  • Direct secure messaging: bmccallister21765@direct.trinity-health.org

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1053388595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 - LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE 203",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8000",
            "fax_number": "734-712-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLISTER",
        "first_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301058673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.