Individual provider Active NPI

Anne Marie Sullivan, MD

  • Diagnostic Radiology Physician
  • Albany, NY
National Provider Identifier
1215161666
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
267059 Issued in NY
Practice address
315 S Manning Blvd
Albany, NY 12208-1707
Phone
(518) 525-1401
Fax
(518) 525-1200
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 267059 NY
Diagnostic Radiology Physician 2085R0202X 267059 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
Albany, NY 12208-1707

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

713 Troy Schenectady Rd Ste 304
Latham, NY 12110-2490
Phone (518) 373-4448

Other practice location 2

1 Tallow Wood Dr
Clifton Park, NY 12065-2807
Phone (518) 373-4448

Other practice location 3

279 Troy Rd
Rensselaer, NY 12144-9518
Phone (518) 880-6300

Other practice location 4

2 Empire Dr
Rensselaer, NY 12144-5730
Phone (518) 286-4899

Other practice location 5

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3482

Other practice location 6

1300 Massachusetts Ave
Troy, NY 12180-1628
Phone (518) 268-5590

Other practice location 7

1270 Belmont Avene
Schenectady, NY 12308-2104
Phone (518) 382-4558

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141008001164 NY Practitioner - Diagnostic Radiology 5799905030 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
267059NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Neuroradiology CurrentSince Sep 11, 2023 Accepting new patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Jul 1, 2014 Accepting new patients
Medical Imaging Center LLP CurrentSince Jun 28, 2014 Accepting new patients
Ellis Hospital CurrentSince Mar 16, 2024 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

37 W Garden St
Ste 107
Auburn, NY 13021
Phone (315) 255-2828

5700 W Genesee St
Ste 7
Camillus, NY 13031
Phone (315) 701-1670

1 Tallow Wood Dr
Clifton Park, NY 12065
Phone (518) 373-4444

5008 Brittonfield Pkwy
Ste 100
East Syracuse, NY 13057
Phone (315) 234-7609

5000 Brittonfield Pkwy
Ste A114
East Syracuse, NY 13057
Phone (315) 472-4701

5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 634-5056

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

279 Troy Rd
Rensselaer, NY 12144
Phone (518) 286-1922

2 Empire Dr
Rensselaer, NY 12144
Phone (518) 286-3990

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

4900 Broad Rd
Ste 1C
Syracuse, NY 13215

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

725 Irving Ave
Ste 209
Syracuse, NY 13210
Phone (315) 472-4364

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

736 Irving Ave
Ste 2499
Syracuse, NY 13210
Phone (315) 472-4364

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Interoperability endpoints

  • Direct secure messaging: asullivan2956447@direct.trinity-health.org

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.

Hospital & facility affiliations 9

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1215161666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1401",
            "fax_number": "518-525-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 Troy Schenectady Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121102490",
            "country_code": "US",
            "telephone_number": "518-373-4448",
            "fax_number": "518-373-4556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Tallow Wood Dr",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120652807",
            "country_code": "US",
            "telephone_number": "518-373-4448",
            "fax_number": "518-373-4556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "279 Troy Rd",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121449518",
            "country_code": "US",
            "telephone_number": "518-880-6300",
            "fax_number": "518-283-4442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Empire Dr",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121445730",
            "country_code": "US",
            "telephone_number": "518-286-4899",
            "fax_number": "518-435-0738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3482",
            "fax_number": "518-271-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5590",
            "fax_number": "518-268-5534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Belmont Avene",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082104",
            "country_code": "US",
            "telephone_number": "518-382-4558",
            "fax_number": "518-386-3614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANNE MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "267059",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "267059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.