A luminous radio burst was recently detected in temporal coincidence with a hard X-ray flare from the Galactic magnetar SGR 1935+2154 with a time and frequency structure consistent with cosmological fast radio bursts (FRB) and a fluence within a factor of 10 of the least energetic extragalactic FRB previously detected. Although active magnetars are commonly invoked FRB sources, several distinct mechanisms have been proposed for generating the radio emission which make different predictions for the accompanying higher frequency radiation. We show that the properties of the coincident radio and X-ray flares from SGR 1935+2154, including their approximate simultaneity and relative fluence E radio /E X ∼ 10 −5 , as well as the duration and spectrum of the X-ray emission, are consistent with extant predictions for the synchrotron maser shock model. Rather than arising from the inner magnetosphere, the X-rays are generated by (incoherent) synchrotron radiation from thermal electrons heated at the same internal shocks which produce the coherent maser emission as ultra-relativistic flare ejecta collides with a slower particle outflow (e.g. as generated by earlier flaring activity) on a radial scale ∼ 10 11 cm. Although the rate of SGR 1935+2154-like bursts in the local universe is not sufficient to contribute appreciably to the extragalactic FRB rate, the inclusion of an additional population of more active magnetars with stronger magnetic fields than the Galactic population can explain both the FRB rate as well as the repeating fraction, however only if the population of active magnetars are born at a rate that is at least two-orders of magnitude lower than that of SGR 1935+2154-like magnetars. This may imply that the more active magnetar sources are not younger magnetars formed in a similar way to the Milky Way population (e.g. via ordinary supernovae), but instead through more exotic channels such as superluminous supernovae, accretion-induced collapse or neutron star mergers.