Individual provider Active NPI

Caroline Ann Callahan

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1962913525
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
271683 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(857) 238-1000
Fax
(857) 238-1089
NPI assigned
Oct 23, 2017
Last updated
Mar 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 271683 MA
Nurse Practitioner 363L00000X 271683 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St # 9
Boston, MA 02114-2621
Phone (857) 238-1000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180426002225 MA Practitioner - Nurse Practitioner 1355605437 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
271683MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Mar 21, 2018 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Mar 21, 2018 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#9
Boston, MA 02114
Phone (617) 724-3874

Interoperability endpoints

  • Direct secure messaging: callahan.caroline.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1962913525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "857-238-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "857-238-1000",
            "fax_number": "857-238-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "CAROLINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "271683",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "271683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.