Brendan Sullivan

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

5101025597 Issued in MI

Practice address

5333 McAuley Dr RM 5011
Ypsilanti, MI 48197-1003

Phone

(734) 712-8700

NPI assigned

Mar 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Addiction MedicineAlso: Internal Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bsullivan448738@direct.hfhs.org
• Direct secure messaging: bsullivan674330@direct.trinity-health.org

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Recovery Specialists

  • Addiction Medicine (Internal Medicine) Physician
  • Ypsilanti, MI
  • NPI 1356793954
  NPD
• Hegira Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westland, MI
  • NPI 1184684979
  NPD (past)
• Iha Health Services Corporation

  dba IHA Milan Primary Care

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1023540853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 5011",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971003",
            "telephone_number": "734-712-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRENDAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": "5101025597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Suddarth, DO
• Catherine Sukpraphrute
• Marwa Sulaiman
• Suzzanne Suleiman, LLP
• Staci Suliman, MSW
• Humayra Nikhat Sullivan, MD
• Mandy J Sullivan, RN
• Ahlam Sultan
• Lori Summers
• Vikram Sundararaghavan

• Addiction Medicine (Internal Medicine) Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Addiction Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.