Individual provider Active NPI

Laura D Sullivan, CRNA

  • Certified Registered Nurse Anesthetist
  • Fall River, MA
National Provider Identifier
1265433122
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
256715 Issued in MA
Practice address
363 Highland Ave
Fall River, MA 02720-3703
Phone
(508) 679-3131
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 256715 MA Primary
Certified Registered Nurse Anesthetist 367500000X 001968 CT

Addresses

Primary practice location

363 Highland Ave
Fall River, MA 02720-3703

Mailing address

53 Tallawanda Rd
Ste. 670
Swansea, MA 02777-1206
Phone (508) 567-1969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090918000156 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769538602 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners of New England LLCGroup PAC ID 2365835428, 39 clinicians

Practice addresses (Care Compare)

440 Swansea Mall Dr
Swansea, MA 02777-4114
Phone (352) 275-2064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
001968CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners of New England, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Apr 1, 2021 Accepting new patients
North American Partners in Anesthesia Massachusetts LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2018 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Narragansett Bay Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2016 Accepting new patients
Anesthesia Associates of New London, PC PastSince Dec 9, 2019 Accepting new patients

Locations

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

300D Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 998-6683

440 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 324-1171

75 Newman Ave
Ste 100
Rumford, RI 02916

Interoperability endpoints

  • Direct secure messaging: lsullivan20530@direct.southcoast.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1265433122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 TALLAWANDA RD",
            "address_2": "STE. 670",
            "city": "SWANSEA",
            "state": "MA",
            "postal_code": "027771206",
            "telephone_number": "508-567-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-679-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "256715",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "001968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.