Benjamin Alexander Sullivan, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0003370 Issued in MD

Practice address

900 Caton Avenue
Baltimore, MD 21229

Phone

(410) 368-2514

Fax

(410) 368-2640

NPI assigned

Dec 5, 2006

Sex

Male

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 MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• St Agnes Healthcare Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176

  Physician Assistant

  Medicare reassignment NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD
• Caton Emergency Physicians

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1003829953

  Physician Assistant

  NPD (past)
• Maryland Provo-I Medical Services, PC

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1013002096

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225196652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 21182",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21228",
            "telephone_number": "410-368-8640",
            "fax_number": "410-368-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21229",
            "telephone_number": "410-368-2514",
            "fax_number": "410-368-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BENJAMIN",
        "middle_name": "ALEXANDER",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Morgan Sullivan-Hvizdos, CF-SLP
• Catherine Mary Sullivan-Windt, PH.D.
• Alicia Lynn Sullivan, PH.D
• Alison L Sullivan, LCSW-C
• Amanda Sullivan, OTR
• Brooke Alexandria Sullivan
• Cari Rose Sullivan, PT
• Catherine Atchison Sullivan, PSYD
• David Sullivan, M.D.
• Eleanor Margaret Sullivan

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.