Asia Jasmine Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56580 Issued in CA

Practice address

5901 W Olympic Blvd Ste 401
Los Angeles, CA 90036-4669

Phone

(310) 651-9017

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DAGJBA/Endpoint/DAGJBA

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1073074332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 7TH CT S APT 1",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352223239",
            "telephone_number": "251-597-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD STE 401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364669",
            "telephone_number": "310-651-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ASIA",
        "middle_name": "JASMINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Sullens
• Veronica Sullins, MD
• Hanorah Sullivan-Houndalas, L.AC., DIPL. AC.
• Andrew Sullivan, PT, DPT
• Angela Marie Sullivan, M.S.
• Corissa Dante' Sullivan
• Hannah Leigh Sullivan
• Kathryn Ann Sullivan, AU.D.
• Lindsay Claire Sullivan, MA
• Maren Sullivan, LCSW

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.