Kristin Marie Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4454 Issued in MA

Practice address

125 Parker Hill Ave
Converse 4
Boston, MA 02120-2847

Phone

(617) 754-6025

Fax

(617) 754-6026

NPI assigned

Sep 24, 2012

Sex

Female

Sole proprietor

No

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 MA

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New England Baptist Medical Associates, Inc.Group PAC ID 2365439783, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New England Baptist Hospital Hospital, Boston, MA, CCN 220088

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: ksullivan252789@direct.bilh.masshiway.net

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.

• New England Baptist Medical Associates, Inc.

  • Internal Medicine Physician
  • Roxbury Crossing, MA
  • NPI 1609854991
  Medicare reassignment Care Compare group
• Orthopaedic Clinical Assoc Inc.

  • Specialist
  • Roxbury Crossing, MA
  • NPI 1578528949
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New England Baptist Hospital

  • General Acute Care Hospital
  • Roxbury Crossing, MA
  • NPI 1699767491
  Care Compare affiliation

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1194076620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "address_2": "CONVERSE 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-6025",
            "fax_number": "617-754-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "address_2": "CONVERSE 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-6025",
            "fax_number": "617-754-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Sullivan, PHARM.D., RPH
• Kathleen Marie Sullivan, NP
• Kathleen Ruth Sullivan, C.N.M.
• Kathryn Sullivan
• Keri J Sullivan, RN, MS, CPNP
• Lara Sullivan, LICSW
• Lauren Michelle Sullivan, RN, AGCNS-BC
• Lee Sullivan, MD
• Leslie Jane Sullivan, NP
• Lily Sullivan, RN

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.