Active NPI
Brian Edward Sullivan, M.D.
- Internal Medicine Physician
- Dubuque, IA
National Provider Identifier
1194771048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 31567
- Practice address
- 1500 Associates Dr
Dubuque, IA 52002-2201 - Phone
- (563) 584-4430
- Fax
- (563) 584-4422
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 31567 | IA | Primary |
Addresses
Primary practice location
1500 Associates Dr
Dubuque, IA 52002-2201
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2156117 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060322000146 | IA | Practitioner - Internal Medicine | 9931117629 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Iowa, RJ & L Carver College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Medical Associates Clinic P CUnified Therapy Services, Inc
Practice addresses (Care Compare)
1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100
4135 Pennsylvania Ave
Dubuque, IA 52002-2628
Hospital & facility affiliations
- In-Home Care Connection Home Health Services
- Unitypoint at Home
- Above and Beyond Home Health
- 24 Hour Care, LLC
- Hospice of Dubuque
- Mercyone Dubuque Medical Center
- Finley Hospital
- Mercyone Dyersville Medical Center
- Stonehill Care Center
- Hawkeye Care Center Dubuque
- Grand Meadows Senior Living & Health Care
- Luther Manor at Hillcrest
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31567 | IA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates Clinic P C | Current | Accepting new patients |
Locations
1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455
1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100
Interoperability endpoints
- bsullivan3937006@direct.trinity-health.org
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospice of Dubuque | Hospice | Contracted Managing Employee | Jan 1, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Dubuque, IA
- NPI 1801890892
Contracted Managing Employee
Organizations & group practices 4
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.
-
- Durable Medical Equipment & Medical Supplies
- Dubuque, IA
- NPI 1811091143
-
- Physical Therapist
- Dubuque, IA
- NPI 1619064086
-
- Occupational Therapist
- Fennimore, WI
- NPI 1639727035
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Skilled Nursing Facility
- Asbury, IA
- NPI 1538906367
Nursing home
-
- Home Health Agency
- Dubuque, IA
- NPI 1720187560
-
- Home Health Agency
- Monticello, IA
- NPI 1649279100
-
- Home Health Agency
- Galena, IL
- NPI 1891084596
-
- Home Health Agency
- Moline, IL
- NPI 1184150419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294790400000",
"number": "1194771048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4100",
"fax_number": "563-584-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4430",
"fax_number": "563-584-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRIAN",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2011-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "31567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2156117",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.