Shaun Paul Sullivan, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD00020213 Issued in WA

Practice address

2980 Squalicum Pkwy
Suite 105
Bellingham, WA 98225-1880

Phone

(360) 647-3377

Fax

(360) 752-3214

NPI assigned

Jul 26, 2006

Last updated

Feb 29, 2008By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bellingham Anesthesia Associates, P.S.

  • Anesthesiology Physician
  • Bellingham, WA
  • NPI 1609893460
  Medicare reassignment NPD
• Providence Wa Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Everett, WA
  • NPI 1669615894
  Medicare reassignment NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1164445235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 SQUALICUM PKWY",
            "address_2": "SUITE 105",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251880",
            "telephone_number": "360-647-3377",
            "fax_number": "360-752-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 SQUALICUM PKWY",
            "address_2": "SUITE 105",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251880",
            "telephone_number": "360-647-3377",
            "fax_number": "360-752-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHAUN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00020213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "50039407",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8601809",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Ann Sullivan, LMHC
• Michael Patrick Sullivan, BA
• Naomi Rebecca Sullivan, M.D.
• Patrick Sullivan
• Rachel Sullivan
• Luke Raymond Summers, P.T.A.
• Summit Sports Chiropractic LLC
• Sharon L Sumner, RN
• Sun Community Service
• Jian Yi Sun, M.D.

• Anesthesiology Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.