Individual provider Active NPI

Dianna Sullivan, NP

  • Nurse Practitioner
  • Lindenhurst, NY
National Provider Identifier
1184548356
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
360123 Issued in NY
Practice address
910 Route 109 Ste a
Lindenhurst, NY 11757-1158
Phone
(631) 991-3235
Fax
(631) 631-3970
NPI assigned
Aug 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 360123 NY Primary

Addresses

Primary practice location

910 Route 109 Ste a
Lindenhurst, NY 11757-1158

Mailing address

910 Route 109 Ste a
Lindenhurst, NY 11757-1158
Phone (631) 991-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine & Rehabilitation of Long Island Past Accepting new patients
Long Island Medical Care Services PC PastSince Jul 13, 2025 Accepting new patients

Organizations & group practices 2

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": "1786147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1184548356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 ROUTE 109 STE A",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571158",
            "telephone_number": "631-991-3235",
            "fax_number": "631-631-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 ROUTE 109 STE A",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571158",
            "telephone_number": "631-991-3235",
            "fax_number": "631-631-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DIANNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-08",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "360123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.