NPIMap

Individual provider Active NPI

Brian M. Sullivan, PAC

  • Surgical Physician Assistant
  • Billings, MT
National Provider Identifier
1154400562
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MED-PAC-LIC-209 Issued in MT
Practice address
2702 8TH Ave N
Billings, MT 59101-1107
Phone
(406) 238-2500
NPI assigned
Nov 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 209 MT
Surgical Physician Assistant 363AS0400X MED-PAC-LIC-209 MT Primary

Addresses

Primary practice location

2702 8TH Ave N
Billings, MT 59101-1107

Mailing address

PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500

Other identifiers 3

IdentifierTypeStateIssuer
122978800OtherWYMDCD PIN
000092473OtherMTBCBS PIN
0434146OtherMTMDCD PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20091217000498 MT Practitioner - Physician Assistant 7416097720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2702 8TH Ave N
Billings, MT 59101-1107
Phone (406) 238-5254

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

2929 10TH Ave N
Billings, MT 59101-0721
Phone (406) 657-4000

710 11TH St N
Columbus, MT 59019-7215
Phone (406) 322-6150

801 N 29TH St
Billings, MT 59101-0905
Phone (406) 238-2500

Hospital & facility affiliations

  • Billings Clinic Hospital Hospital, Billings, MT, CCN 270004
  • Stillwater Billings Clinic Hospital, Columbus, MT, CCN 271330
  • Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049
  • Beartooth Billings Clinic Hospital, Red Lodge, MT, CCN 271326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
209MTMDPhysician Assistant
MED-PAC-LIC-209MTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Jul 2, 1999 Accepting new patients
Stillwater Hospital Association, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Billings Clinic CurrentSince Jul 2, 1999 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

2702 8th Ave N
Billings, MT 59101
Phone (406) 238-2769

1202 3rd St W
Roundup, MT 59072
Phone (406) 323-2301

Interoperability endpoints

  • Direct secure messaging: bsullivan@billingsclinic.cernerdirect.com

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 12

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": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1154400562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100",
            "telephone_number": "406-238-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 8TH AVE N",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591011107",
            "telephone_number": "406-238-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRIAN",
        "middle_name": "M.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "209",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "MED-PAC-LIC-209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCD PIN",
            "identifier": "122978800",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "000092473",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCD PIN",
            "identifier": "0434146",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.