NPIMap

Individual provider Active NPI

Amanda Callum, PA

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1306699269
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA100681 Issued in MA
Practice address
725 Albany St Ste 4B
Boston, MA 02118-3549
Phone
(617) 638-5633
NPI assigned
Apr 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA100681 MA Primary

Addresses

Primary practice location

725 Albany St Ste 4B
Boston, MA 02118-3549

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690

Other practice location 1

39B District Ave
Dorchester, MA 02125-1683
Phone (617) 638-7869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805000787 MA Practitioner - Physician Assistant 0547707812 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Orthopaedic Surgical Associates IncGroup PAC ID 0143297655, 36 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-5633

725 Albany St
Boston, MA 02118-2526
Phone (617) 638-5633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA100681MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 25, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2024 Accepting new patients
Boston University Family Medicine, Inc. PastSince Dec 8, 2024 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

39B District Ave
Dorchester, MA 02125
Phone (617) 638-7869

Interoperability endpoints

  • Direct secure messaging: acallum251124@direct.bmc.masshiway.net

Organizations & group practices 8

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 8

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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1306699269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST STE 4B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-638-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39B District Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021251683",
            "country_code": "US",
            "telephone_number": "617-638-7869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLUM",
        "first_name": "AMANDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.