Mark C Sullivan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0238P Issued in NH

Practice address

333 Borthwick Avenue
Suite 402
Portsmouth, NH 03801

Phone

(603) 559-4111

Fax

(603) 663-6822

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NH

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.sullivan@hca6.eclinicaldirectplus.com

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.

• Appledore Medical Group, Inc

  • Internal Medicine Physician
  • Portsmouth, NH
  • NPI 1720077167
  Medicare reassignment Care Compare group NPD
• Catholic Medical Center

  • Vascular Surgery Physician
  • Manchester, NH
  • NPI 1235370057
  Medicare reassignment NPD
• Appledore Medical Group II Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portsmouth, NH
  • NPI 1881683415
  NPD (past)
• Cardiothoracic Surgical Associates, P.a.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Manchester, NH
  • NPI 1447235395
  NPD (past)

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

• HCA Health Services of New Hampshire Inc

  • General Acute Care Hospital
  • Portsmouth, NH
  • NPI 1518913607
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1225075328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVENUE",
            "address_2": "SUITE 402",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-559-4111",
            "fax_number": "603-559-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVENUE",
            "address_2": "SUITE 402",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-559-4111",
            "fax_number": "603-663-6822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Borthwick Ave",
            "address_2": "SUITE 402",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038017128",
            "country_code": "US",
            "telephone_number": "603-559-4111",
            "fax_number": "603-559-4110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-10-04",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA 880",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0238P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076816",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staff_wb@gohnh.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "100 McGregor St",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031023730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PORTSMOUTH.COCQE.NHA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "address_1": "333 Borthwick Ave",
            "address_2": "SUITE 402",
            "city": "Portsmouth",
            "state": "NH",
            "country_code": "US",
            "postal_code": "038017128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nagarjun Subash
• Eli James Sugarman, MD
• Christine Suhesky
• Dara Osama Abdallah Suleiman, M.D.
• Janelle Sullivan, BCHN
• Timothy W Sullivan, MD
• Sunbridge Clipper Home of Portsmouth LLC
• Lauren Anna Super, BA
• Susan a Murray MD PLLC
• Susan Krolewski

• Surgical Physician Assistant in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Surgical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.