Individual provider Active NPI

Marcelo Cavalcante Campos, MD

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1790770121
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
220046 Issued in MA
Practice address
147 Milk St
Boston, MA 02109-4806
Phone
(617) 654-7200
NPI assigned
Sep 12, 2005
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 220046 MA Primary

Addresses

Primary practice location

147 Milk St
Boston, MA 02109-4806

Mailing address

147 Milk St
Boston, MA 02109-4806
Phone (617) 654-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcamposmd73250@direct.atrius.masshiway.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022000316 MA Practitioner - Family Practice 5890756837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
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)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

1250 Hancock St
Quincy, MA 02169-4339
Phone (617) 740-0600

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

142 Berkeley St
Boston, MA 02116-5100
Phone (617) 859-5000

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

36 Shops at 5 Way
Plymouth, MA 02360-2677
Phone (774) 608-3700

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6000

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Feb 28, 2013 Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 28, 2013 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

147 Milk St
Fl 3
Boston, MA 02109
Phone (617) 654-7280

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

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

Interoperability endpoints

  • Direct secure messaging: mcamposmd73250@direct.atrius.masshiway.net

Organizations & group practices 6

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 1

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1790770121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-654-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-654-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "MARCELO",
        "middle_name": "CAVALCANTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "220046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcamposmd73250@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "147 Milk St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021094806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.