NPIMap

Individual provider Active NPI

Benjamin Will Scallon, M.D.

  • Internal Medicine Physician
  • Boulder, CO
National Provider Identifier
1376923250
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0074853 Issued in CO
Practice address
1645 Broadway
Boulder, CO 80302-6218
Phone
(303) 415-8900
Fax
(303) 443-6476
NPI assigned
Jun 4, 2015
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD463687 PA
Internal Medicine Physician 207R00000X R-10311 IA
Internal Medicine Physician 207R00000X 305535 NY
Internal Medicine Physician 207R00000X DR.0074853 CO Primary

Addresses

Primary practice location

1645 Broadway
Boulder, CO 80302-6218

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-4101

Other practice location 1

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

Other practice location 2

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 384-9668

Other practice location 3

425 E 61st St
New York, NY 10065-8722
Phone (646) 962-2399

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address bws9005@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250812004733 CO Practitioner - Internal Medicine 3779895487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

1645 Broadway
Boulder, CO 80302-6218
Phone (303) 415-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0074853COMDInternal Medicine Physician
MD463687PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Internal Medicine Current Accepting new patients
Boulder Community Health CurrentSince Sep 8, 2025 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

1645 Broadway
Boulder, CO 80302
Phone (303) 415-8900

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

Interoperability endpoints

  • Direct secure messaging: bws9005@direct.nyp.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1376923250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-415-4101",
            "fax_number": "303-415-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 BROADWAY",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803026218",
            "telephone_number": "303-415-8900",
            "fax_number": "303-443-6476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Geisinger Ln",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "17044",
            "country_code": "US",
            "telephone_number": "717-242-4200",
            "fax_number": "717-242-4212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-384-9668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 E 61st St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100658722",
            "country_code": "US",
            "telephone_number": "646-962-2399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCALLON",
        "first_name": "BENJAMIN",
        "middle_name": "WILL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD463687",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R-10311",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "305535",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0074853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bws9005@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.