NPIMap

Organization Active NPI

Steward Medical Group, Inc

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1255600300
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STEWARD MEDICAL GROUP, INC
Practice address
500 Boylston St
Boston, MA 02116-3740
Phone
(615) 467-4158
Fax
(615) 467-1267
NPI assigned
Dec 19, 2011
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
STEWARD HEALTHCARE SYSTEM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Michael Callum
Title
Ceo
Phone
(617) 419-4702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU

Addresses

Primary practice location

500 Boylston St
Boston, MA 02116-3740

Mailing address

500 Boylston St
Boston, MA 02116-3740
Phone (617) 419-4700

Other names 1

  • SMG Compass Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120430000164 MA Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 162 practitioners
Practice locations: Taunton, MA; South Easton, MA; Quincy, MA; Middleboro, MA; East Bridgewater, MA; Halifax, MA; Abington, MA; Braintree, MA…

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Steward Physician Network Inc60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

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

View all 16

Locations

1 Compass Way
Ste 200
East Bridgewater, MA 02333
Phone (508) 350-2300

430 Plymouth St
Ste 100
Halifax, MA 02338
Phone (781) 422-2900

21 Bristol Dr
Ste 200
South Easton, MA 02375
Phone (508) 565-7300

152 Dean St
Bldg 3
Taunton, MA 02780
Phone (508) 824-3782

Practitioners & affiliated clinicians

Practitioners 174

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 174

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1255600300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163740",
            "telephone_number": "617-419-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163740",
            "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 HEALTHCARE SYSTEM LLC",
        "enumeration_date": "2011-12-19",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "CALLUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-419-4702"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMG Compass",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SMG Compass",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.