Stephen R Sullivan, M.D., M.P.H.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

233018 Issued in MA

Practice address

300 Mount Auburn St Ste 304
Cambridge, MA 02138-5665

Phone

(617) 492-0620

Fax

(617) 492-0631

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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 MA

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

Specialty

Plastic and Reconstructive Surgery

Education

University of Washington School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Taylor Sullivan Plastic Surgery LLCGroup PAC ID 6901251727, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssullivan253577@direct.bilh.masshiway.net
• FHIR API: https://api.platform.athenahealth.com/86/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.

• Taylor Sullivan Plastic Surgery LLC

  • Plastic Surgery Physician
  • Cambridge, MA
  • NPI 1558149237
  Medicare reassignment Care Compare group NPD
• Mount Auburn Professional Services Inc

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1992750996
  Medicare reassignment NPD
• Taylor and Sullivan Plastic Surgery

  • Plastic Surgery Physician
  • Cambridge, MA
  • NPI 1376072116
  NPD Authorized official
• Mt Auburn Professional Services

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1013375203
  NPD

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

• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1154412906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN STREET",
            "address_2": "SUITE 304",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-492-0620",
            "fax_number": "617-492-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST STE 304",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385665",
            "telephone_number": "617-492-0620",
            "fax_number": "617-492-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-08-10",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "233018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liam Sullivan
• Mary Ann Sullivan, RN
• Nadia Sullivan
• Ryan J Sullivan, MD
• Sridevi Sullivan, MD
• Emily Bousquin Sulloway, MS, RDN, LDN
• Heidi Bruggink Sulman, LCSW
• Kyle Sultzer
• Tasnima Siddiqa Sumaiya
• Summer Eyes Optometry, Inc

• Plastic Surgery Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Plastic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.