NPIMap

Individual provider Active NPI

Myfanwy G Callahan, M.D.

  • Internal Medicine Physician
  • Medford, MA
National Provider Identifier
1538428685
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
263178 Issued in MA
Practice address
26 City Hall Mall
Medford, MA 02155-4754
Phone
(781) 306-5130
Fax
(781) 306-5083
NPI assigned
May 10, 2012
Last updated
Jan 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 263178 MA Primary

Addresses

Primary practice location

26 City Hall Mall
Medford, MA 02155-4754

Mailing address

26 City Hall Mall
Medford, MA 02155-4754
Phone (781) 306-5130

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcallahanmd176782@direct.atrius.masshiway.net

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
I20151012001588 MA Practitioner - Internal Medicine 1456583442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

26 City Hall Mall
Medford, MA 02155-4754
Phone (781) 306-5100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Atrius Health, Inc. Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Atrius Health, Inc. Internal Medicine Current Accepting new patients
Atrius Health, Inc. Internal Medicine Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

26 City Hall Mall
Medford, MA 02155
Phone (781) 306-5100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1538428685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5130",
            "fax_number": "781-306-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5130",
            "fax_number": "781-306-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MYFANWY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "263178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcallahanmd176782@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "26 City Hall Mall",
            "city": "Medford",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021554754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.