Erin Sullivan-Baca, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

38638 Issued in TX

Practice address

2301 Ohio Dr Ste 130
Plano, TX 75093-3997

Phone

(214) 228-5180

NPI assigned

Apr 8, 2021

Sex

Female

Sole proprietor

Yes

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurocognitive Specialty Group PLLCGroup PAC ID 9133451297, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Neurocognitive Specialty Group, PLLC

  • Clinical Neuropsychologist
  • League City, TX
  • NPI 1346700275
  Medicare reassignment Care Compare group NPD
• Dr Associates of North Texas

  • Clinical Neuropsychologist
  • Plano, TX
  • NPI 1790050375
  NPD

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1174103758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7157 NICOLE PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752526100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 OHIO DR STE 130",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933997",
            "telephone_number": "214-228-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-BACA",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Tabakman Sukenik, O.D.
• Adebola Sulaiman
• Suraj Sulhan, MD
• Lee Mary Sulkin, NP
• Sullivan Chiropractic Centers, PA
• Adriana Sullivan
• Anne Sullivan
• John Perry Sullivan, MD
• Timothy Sullivan, M.D.
• Timothy E Sullivan, DC

• Psychologist in Plano, TX
• Providers in Plano, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.