Individual provider Active NPI

Robert Edwin O' Sullivan, MD

  • Obstetrics & Gynecology Physician
  • Rancho Mirage, CA
National Provider Identifier
1053751271
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C209010 Issued in CA
Practice address
71943 Highway 111
Rancho Mirage, CA 92270-4848
Phone
(760) 834-7982
Fax
(760) 834-7981
NPI assigned
Jul 2, 2013
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C209010 CA Primary
Obstetrics & Gynecology Physician 207V00000X 55690 CT

Addresses

Primary practice location

71943 Highway 111
Rancho Mirage, CA 92270-4848

Mailing address

71943 Highway 111
Rancho Mirage, CA 92270-4848
Phone (760) 834-7982

Other practice location 1

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3202
Phone (760) 340-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20170630001374 CT Practitioner - Obstetrics/Gynecology 5496024655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

982 E Main St
Bridgeport, CT 06608-1913
Phone (203) 696-3260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55690CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Obstetrics & Gynecology CurrentSince Jul 1, 2017 Accepting new patients
Optimus Health Care Inc CurrentSince Apr 21, 2021 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: rosullivan120075@direct.ynhh.org

Organizations & group practices 2

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1053751271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71943 HIGHWAY 111",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704848",
            "telephone_number": "760-834-7982",
            "fax_number": "760-834-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71943 HIGHWAY 111",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704848",
            "telephone_number": "760-834-7982",
            "fax_number": "760-834-7981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39000 Bob Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922703202",
            "country_code": "US",
            "telephone_number": "760-340-3911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O' SULLIVAN",
        "first_name": "ROBERT",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C209010",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "55690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.