Individual provider Active NPI

Brian D Callahan

  • Nurse Practitioner
  • Boiceville, NY
National Provider Identifier
1932153301
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F330832 Issued in NY
Practice address
480 State Route 28
Suite 1
Boiceville, NY 12412-2820
Phone
(845) 657-7820
Fax
(845) 657-6016
NPI assigned
May 20, 2006
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F330832 NY Primary
Family Nurse Practitioner 363LF0000X F330832 NY

Addresses

Primary practice location

480 State Route 28
Suite 1
Boiceville, NY 12412-2820

Mailing address

480 State Route 28
Suite 1
Boiceville, NY 12412-2820
Phone (845) 657-7820

Other identifiers 1

IdentifierTypeStateIssuer
01927462MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000617 NY Practitioner - Nurse Practitioner 5890736177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of the Hudson ValleyGroup PAC ID 2860384674, 24 clinicians

Practice addresses (Care Compare)

7 -9 Mt Ava Maria Dr
Phoenicia, NY 12464-5102
Phone (845) 338-7140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F330832NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Associates New York PC Current Accepting new patients
Physicians Medical Associates New York PC CurrentSince Jul 1, 2024 Accepting new patients
Medical Associates of the Hudson Valley CurrentSince Apr 8, 2022 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 1, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jan 1, 2020 Accepting new patients
Adirondack Emergency Medicine, PC Past Accepting new patients
Medical Associates of the Hudson Valley PastSince Mar 12, 2024 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

105 Marys Ave
Kingston, NY 12401
Phone (845) 334-3080

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

42084 State Highway 28
Margaretville, NY 12455
Phone (845) 334-2819

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

9 Elwyn Ln
Woodstock, NY 12498
Phone (845) 338-7140

Interoperability endpoints

  • Direct secure messaging: bcallahan@mahv.medentdirect.com

Organizations & group practices 7

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 5

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1932153301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 STATE ROUTE 28",
            "address_2": "SUITE 1",
            "city": "BOICEVILLE",
            "state": "NY",
            "postal_code": "124122820",
            "telephone_number": "845-657-7820",
            "fax_number": "845-657-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 STATE ROUTE 28",
            "address_2": "SUITE 1",
            "city": "BOICEVILLE",
            "state": "NY",
            "postal_code": "124122820",
            "telephone_number": "845-657-7820",
            "fax_number": "845-657-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "BRIAN",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F330832",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01927462",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boiceville, NY

Sources for this page

Verify at the official NPI Registry.