Bradley Sullivan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40764 Issued in CA

Practice address

3555 Whipple Rd
Union City, CA 94587-1507

Phone

(510) 675-4010

NPI assigned

Dec 10, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Precision Health and Rehabilitation

  • Physical Therapist
  • Santa Cruz, CA
  • NPI 1316010523
  NPD (past)

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1104257641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 WHIPPLE RD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945871507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 WHIPPLE RD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945871507",
            "telephone_number": "510-675-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRADLEY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3555 Whipple Rd",
            "city": "Union City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kalyn Lee Starkweather
• Stellar Care Advocates, Inc.
• Andrew Ludlow Stern, MFT
• Alexa Stevens, M.A. - CCC SLP
• Benny Granado Sulit Jr.
• Scott Douglas Sullivan, M.D.
• Susan M. Kwong, DDS, Apdc
• Ajanta Swarnakar, M.D.
• Valerie Lynne Dawod Sweilem, MS, CCC-SLP
• Sylvan Speech and Language Therapy

• Physical Therapist in Union City, CA
• Providers in Union City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.