STEWARD MEDICAL GROUP, INC (NPI# 1629398219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629398219 |
| Entity Type | Organization |
| Organization Name | STEWARD MEDICAL GROUP, INC |
| Other Organization Name | STEWARD PHYSICIAN NETWORK, INC |
| Practice Address |
77 Warren St Brighton MA 02135-3601 |
| Practice Telephone | 6154674158 |
| Practice Fax Number | 6154671267 |
| Mailing Telephone | 6175625359 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | MICHAEL J CALLUM (CEO OF STEWARD PHYSICIAN NETWORK) |
| Authorized Official Telephone | 6177796303 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | STEWARD HEALTH CARE SYSTEM LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Steward Physician Network, Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255600300 | Steward Medical Group, Inc | Internal Medicine | 500 Boylston St, Boston, MA 02116-3740 | 2011-12-19 |
| 1972073716 | Steward Medical Group, Inc | Radiology | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-12-04 |
| 1134697923 | Steward Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 531 Faunce Corner Rd, North Dartmouth, MA 02747-1242 | 2018-11-09 |
| 1043711914 | Steward Medical Group, Inc | Nurse Anesthetist, Certified Registered | 795 Middle St, Fall River, MA 02721-1733 | 2018-02-26 |
| 1962881078 | Steward Medical Group, Inc | Clinic/Center | 1 Pearl St, Suite 1800, Brockton, MA 02301-2864 | 2015-05-21 |
| 1780937326 | Steward Medical Group, Inc | Physical Therapist | 535 Faunce Corner Rd, Dartmouth, MA 02747-1242 | 2012-10-19 |
| 1821349317 | Steward Medical Group, Inc | Internal Medicine | 535 Faunce Corner Rd, Dartmouth, MA 02747-1242 | 2012-09-25 |
| 1336496405 | Steward Medical Group, Inc | Physical Medicine & Rehabilitation | 500 Boylston St, Boston, MA 02116-3740 | 2012-08-08 |
| 1013220151 | Steward Medical Group, Inc | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| 1356654495 | Steward Medical Group, Inc | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | STEWARD MEDICAL GROUP, INC. | 28 Liberty St., New York, Ny 10005 |
| Massachusetts Corporations | STEWARD MEDICAL GROUP, INC. | 500 Boylston St., Boston, MA 02116 |
| Street Address |
77 WARREN ST |
| City | BRIGHTON |
| State | MA |
| Zip Code | 02135-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235131194 | Roger F Cohen | Clinical Neuropsychologist | 77 Warren St, Suite 453, Brighton, MA 02135-3601 | 2005-08-11 |
| 1699383489 | Rhianna Candido | Registered Nurse | 77 Warren St, Brighton, MA 02135-3601 | 2020-07-17 |
| 1770101586 | Jennie Vaughan Hollyday | Peer Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2020-07-08 |
| 1922620863 | Jonathan Kolodziej | Social Worker | 77 Warren St, Brighton, MA 02135-3601 | 2020-05-14 |
| 1114401098 | Hayley Youngstrom | Social Worker | 77 Warren St, Brighton, MA 02135-3601 | 2018-09-18 |
| 1548744436 | Kelsey Elizabeth Connolly | Social Worker | 77 Warren St, Brighton, MA 02135-3601 | 2018-09-18 |
| 1629551585 | Caitlyn Burns | Counselor | 77 Warren St, Brighton, MA 02135-3601 | 2018-09-07 |
| 1790294981 | Evan Moran Queenan | Counselor | 77 Warren St, Brighton, MA 02135 | 2017-09-20 |
| 1609395615 | Hannah Goehner | Student in an Organized Health Care Education/Training Program | 77 Warren St, Brighton, MA 02135-3601 | 2017-09-12 |
| 1669990727 | Yasmin A Santos | Registered Nurse | 77 Warren St, Brighton, MA 02135 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699392944 | Nur Zeynep Ay | Student in an Organized Health Care Education/Training Program | 736 Cambridge Street St Elizabeths Medical Center, Graduate Medical Education (diane Giacalone), Boston, MA 02135 | 2020-07-02 |
| 1104470673 | Domenique Delucia | Counselor | 77f Warren Street, Brighton, MA 02135 | 2019-08-01 |
| 1831751684 | Meredith Mcghee | Audiologist | 736 Cambridge Street Smc-8, Brighton, MA 02135 | 2019-07-02 |
| 1730645847 | Delphine Alignol | Family Medicine | 330 Mount St, Cambridge, MA 02135 | 2019-02-13 |
| 1124501960 | Ellen Elizabeth Miller | Social Worker | 44 Mt Vernon St, Brighton, MA 02135 | 2018-09-07 |
| 1710466180 | Sharon Pae | Acupuncturist | 135 Chiswick Rd Bsmt, Brighton, MA 02135 | 2018-08-07 |
| 1750877155 | Leonid Sigal | Counselor | 9 South St Apt 2, Brighton, MA 02135 | 2018-07-09 |
| 1689165425 | Brian George Mcguire | Dentist | 24 Sidlaw Rd, Brighton, MA 02135 | 2018-05-29 |
| 1619467214 | Ashley Marie Arbuckle | Counselor | 77 Waren Street, Building 9, Brighton, MA 02135 | 2018-05-18 |
| 1871098962 | Arina Sorokina | Dentist | Charles River Community Health Center, 495 Western Avenue, Allston, MA 02135 | 2018-03-29 |
| Find all providers in zip 02135 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477036812 | Andrea Odonnell | Specialist | 9795 Village Place Blvd, Sola Studio 15, Brighton, MI 48116-2087 | 2018-09-12 |
| 1104229723 | Kara Elisabeth Sullivan | Specialist | 40 Montcalm Ave Unit 1, Brighton, MA 02135 | 2014-09-28 |
| 1578994463 | Gago Ivf | Specialist | 2250 Genoa Business Park Dr Ste 110, Brighton, MI 48114-7372 | 2013-12-03 |
| 1386085322 | Trisha Conklin | Specialist | 102 Pelican Ave, Brighton, CO 80601-5314 | 2013-07-06 |
| 1992144315 | Christine Rans | Specialist | 4160 Summer Hl, Brighton, MI 48116-9777 | 2013-06-19 |
| 1891054375 | Affinity | Specialist | 1041 Lincoln Dr, Brighton, MI 48116-3793 | 2012-05-03 |
| 1750573010 | Platte Valley Internal Medicine & Pulmonary LLC | Specialist | 1606 Prairie Center Pkwy Ste 310, Brighton, CO 80601-4004 | 2007-08-10 |
| 1164594081 | West Clinic PC | Specialist | 240 Grandview Drive, Brighton, TN 38011-4253 | 2006-11-15 |
| 1326142704 | Carney Medical Group | Specialist | 77 Warren Street-provider Enrollment, Brighton, MA 02135 | 2006-09-07 |
| 1467566885 | Brighton Medical Practice | Specialist | 39 W Woodlawn Ave, Brighton, TN 38011-4139 | 2006-08-19 |
| Find all providers in BRIGHTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.