NPIMap

Individual provider Active NPI

Ryan Sullivan

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1124554571
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0066232 Issued in CO
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-2200
NPI assigned
May 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DR.0066232 CO Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610000454 CO Practitioner - Internal Medicine 2769892355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

274 Union Blvd
Suite 200
Lakewood, CO 80228-1835
Phone (303) 951-0600

Hospital & facility affiliations

  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104
  • AdventHealth Littleton Hospital, Littleton, CO, CCN 060113
  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
  • AdventHealth Porter Hospital, Denver, CO, CCN 060064
  • AdventHealth Parker Hospital, Parker, CO, CCN 060114

Merit-based Incentive Payment System (MIPS)

Final score
91.27 of 100Reported as group
Quality
80.01
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0066232COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Critical Care & Pulmonary Consultants, PC CurrentSince Jul 1, 2022 Accepting new patients
Critical Care Pulmonary and Sleep Associates Professional LLP Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Critical Care Pulmonary and Sleep Associates Professional LLP CurrentSince Jun 8, 2025 Accepting new patients
Philippe G Lopez MD PC CurrentSince Jun 16, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 1, 2021 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

7100 E Belleview Ave
Ste G10
Greenwood Village, CO 80111
Phone (303) 745-0000

274 Union Blvd
Ste 200
Lakewood, CO 80228
Phone (303) 778-5666

Organizations & group practices 6

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1124554571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0066232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.