Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Katherine Maccallum, MD

Individual provider Vascular Surgery Physician · NPI 1194110189

Dr. Katherine Maccallum, MD is a Vascular Surgery in Providence, Rhode Island. Qualified in 2015, 11 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts, New York and Rhode Island.

Years since qualifying
11
Licensed in
MA, NY, RI
In the registry since
2015
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2 Dudley St Ste 470
Providence, RI 02905-3248
Phone: (401) 553-8325
Fax: (401) 868-2336
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence MD18473 (RI)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 293441 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1194110189
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 6, 2015
Last updated in NPPESSeptember 21, 2022
Certification dateApril 18, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Providence