Individual provider Active NPI

Mary McCabe, D.D.S.

  • Dentist
  • New Bedford, MA
National Provider Identifier
1689608564
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18424 Issued in MA
Practice address
874 Purchase St
New Bedford, MA 02740-6232
Phone
(508) 992-6553
Fax
(508) 990-7558
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18424 MA Primary

Addresses

Primary practice location

874 Purchase St
New Bedford, MA 02740-6232

Mailing address

874 Purchase St
New Bedford, MA 02740-6232
Phone (508) 992-6553

Other identifiers 6

IdentifierTypeStateIssuer
42675800OtherMADELTA DENTAL
40375OtherMAHARVARD PILGRIM
0201863MedicaidMA
24924OtherMANEIGHBORHOOD HEALTH PLAN
8953-7OtherMABCBSRIBLUECROSSDENTAL
X08285OtherMADENTAL BLUE BCBSMA

Other names 1

  • Mary E. Callanan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190708002568 RI Practitioner - Dentist 1951673383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18424MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Action, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Comprehensive Community Action, Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

311 Doric Ave
Cranston, RI 02910
Phone (401) 467-9610

1090 Cranston St
Cranston, RI 02920
Phone (401) 467-9610

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1689608564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 PURCHASE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406232",
            "telephone_number": "508-992-6553",
            "fax_number": "508-990-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 PURCHASE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406232",
            "telephone_number": "508-992-6553",
            "fax_number": "508-990-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "MARY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "18424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "42675800",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "40375",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201863",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "24924",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRIBLUECROSSDENTAL",
            "identifier": "8953-7",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BLUE BCBSMA",
            "identifier": "X08285",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CALLANAN",
            "middle_name": "E.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.