Individual provider Active NPI

Kristin Mary O'Sullivan, M.D.

  • Pediatrics Physician
  • Mountain View, CA
National Provider Identifier
1245558980
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A-112124 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7800
NPI assigned
May 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A-112124 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Mailing address

2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-6203
Phone (650) 934-7800

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110929000320 MA Practitioner - Pediatric Medicine 8628249380 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A-112124CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Pediatrics CurrentSince Apr 25, 2023 Accepting new patients
Northampton Area Pediatrics, LLP Pediatrics Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1245558980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "650-934-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "KRISTIN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-05",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A-112124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.