Individual provider Active NPI

Patrick O. Sullivan, D.O.

  • Emergency Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1154536738
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS019674 Issued in PA
Practice address
2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone
(856) 488-6816
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MB08239800 NJ
Emergency Medicine Physician 207P00000X OS019674 PA Primary

Addresses

Primary practice location

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070913000733 NJ Practitioner - Emergency Medicine 4981798550 Reassigns benefits to 1 organization
I20190305000871 PA Practitioner - Emergency Medicine 4981798550 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB08239800NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Emergency Medicine Current Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Aug 6, 2019 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Dec 9, 2018 Accepting new patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Jul 1, 2007 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Aug 6, 2019 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Dec 9, 2018 Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

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.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1154536738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022048",
            "telephone_number": "856-488-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICK",
        "middle_name": "O.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MB08239800",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS019674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.