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NPI Code Detail

MEDICARE: SCOTT S. CALLEN CRNA

MEDICARE: SCOTT S. CALLEN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN10000289MA
2367500000XCertified Registered Nurse Anesthetist4006657KY
3367500000XCertified Registered Nurse Anesthetist0024188439VA
4367500000XCertified Registered Nurse Anesthetist484280NY
5367500000XCertified Registered Nurse AnesthetistARNP3253332FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649220583
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT S. CALLEN CRNA
Provider Business Mailing Address
First Line : PROVIDER ENROLLMENT 41 MALL ROAD
Second Line :
City : BURLINGTON
State : MA
Zip : 01805-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 85 HERRICK ST
Second Line :
City : BEVERLY
State : MA
Zip : 01915-1790
Country : US
Telephone Number : 978-816-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 12/03/2025

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