Individual provider Active NPI

Mary Elizabeth Calabrese, DO

  • Developmental - Behavioral Pediatrics Physician
  • Fairfax, VA
National Provider Identifier
1881124824
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
0102207915 Issued in VA
Practice address
8280 Willow Oaks Corporate Dr Ste 300
Fairfax, VA 22031-4526
Phone
(571) 472-4300
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125070441 IL
Pediatrics Physician 208000000X 283393 MA
Developmental - Behavioral Pediatrics Physician 2080P0006X 0102207915 VA Primary

Addresses

Primary practice location

8280 Willow Oaks Corporate Dr Ste 300
Fairfax, VA 22031-4526

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-7025

Other practice location 1

1645 W Jackson Blvd
Chicago, IL 60612-3276
Phone (312) 942-2200

Other practice location 2

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-7025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcalabrese1178417@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20231023002084 DC Practitioner - Pediatric Medicine 7416303706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125070441ILMDPediatrics Physician
283393MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Sep 5, 2023 Accepting new patients
Inova Health Care Services Pediatrics CurrentSince Sep 5, 2023 Accepting new patients

Locations

8280 Willow Oaks Corporate Dr
Ste 300
Fairfax, VA 22031
Phone (571) 200-1839

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

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

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1881124824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8280 WILLOW OAKS CORPORATE DR STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314526",
            "telephone_number": "571-472-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 W Jackson Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123276",
            "country_code": "US",
            "telephone_number": "312-942-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-7025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "MARY ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125070441",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "283393",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "VA",
            "license": "0102207915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcalabrese1178417@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8280 Willow Oaks Corporate Dr Ste 300",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.