Individual provider Active NPI

Haley Brooke Sullivan, PA-C

  • Physician Assistant
  • Panama City, FL
National Provider Identifier
1184424152
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
500 W 11TH St
Panama City, FL 32401-6304
Phone
(850) 785-8557
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

500 W 11TH St
Panama City, FL 32401-6304

Mailing address

12109 County Road 103
Oxford, FL 34484-2951
Phone (352) 205-8981

Other names 1

  • Haley Brooke Sullivan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611002588 FL Practitioner - Physician Assistant 3274043989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

500 W 11TH St
Panama City, FL 32401-6304
Phone (850) 785-8557

609 W Highland Blvd
Inverness, FL 34452-4638
Phone (352) 726-9707

Hospital & facility affiliations

  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC CurrentSince Jul 7, 2025 Accepting new patients
Advanced Urology Institute, LLC CurrentSince Jul 7, 2025 Accepting new patients
Advanced Urology Institute LLC Past Accepting new patients

Locations

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

500 W 11th St
Panama City, FL 32401
Phone (850) 785-8557

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

Organizations & group practices 3

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 3

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1184424152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324016304",
            "telephone_number": "850-785-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "HALEY",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "SULLIVAN",
            "middle_name": "BROOKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.