Richard Patrick Sullivan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

142774 Issued in NY

Practice address

3101 Ridge Rd W
Building C
Rochester, NY 14626-3249

Phone

(585) 225-1700

Fax

(585) 225-1439

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western New York Immediate Medical Care LLC

  • Urgent Care Clinic/Center
  • Williamsville, NY
  • NPI 1316014491
  NPD
• Western New York Immediate Medical Care LLC

  • Emergency Medicine Physician
  • Orchard Park, NY
  • NPI 1427224625
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1023168796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 RIDGE RD W",
            "address_2": "BUILDING C",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146263249",
            "telephone_number": "585-225-1700",
            "fax_number": "585-225-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 RIDGE RD W",
            "address_2": "BUILDING C",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146263249",
            "telephone_number": "585-225-1700",
            "fax_number": "585-225-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RICHARD",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "142774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00740996",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Sullivan, FNP
• John P Sullivan, LCSW-R
• John Peter Sullivan, CSW
• Maranda Sullivan
• Rhonda Sullivan, LPN
• Shannon Sullivan, MSW
• Terri Ryan Sullivan, RDH
• Wendy L Sullivan, M.S. CCC-SLP
• David Sullo, MD
• Muhammad Akbar Sulman

• Pediatrics Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.