Brendan James Sullivan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

295780 Issued in NY

Practice address

80 Maiden LN Ste 900
New York, NY 10038-4811

Phone

(917) 261-4414

Fax

(917) 261-4420

NPI assigned

Jun 27, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15349/brand/1/csg/1/fhir/r4

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.

• Inner-City Muslim Action Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1003244567

  Internal Medicine

  Medicare reassignment NPD
• Eden Health Medical of VA PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1366113151
  NPD
• Inner-City Muslim Action Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1073106621
  NPD
• Atlas Health, LLC

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1548839012

  Internal Medicine

  NPD (past)
• Eden Health Medical of Il LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1083297469
  NPD (past)
• Hunterdon Specialty Care, PC

  • Gastroenterology Physician
  • Flemington, NJ
  • NPI 1790156388
  NPD (past)

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1144660754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LIBERTY PLZ STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061404",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAIDEN LN STE 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384811",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 5th Ave Fl 10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100365114",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 S Dearborn St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606035517",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 S Clinton St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212245730",
            "country_code": "US",
            "telephone_number": "866-233-6925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Post Office Sq",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021092106",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 Main Street",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "06103",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRENDAN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2024-06-05",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "63815",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D87163",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036150346",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "272839",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "256259",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10635600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "295780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Sullivan, LMSW
• Andrea Sullivan
• Ashley Sullivan
• Aubin Gay Sullivan, PT
• Aurora Rose Sullivan, MD
• Brian William Sullivan, RPA
• Bridget Anne Sullivan, PA
• Caitlin Colleen Sullivan, MS, CCC-SLP
• Caitlyn Nicole Sullivan, LMSW
• Caroline Sullivan

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.