Individual provider Active NPI

Patricia E Sullivan, M.D.

  • Emergency Medicine Physician
  • Plymouth, MA
National Provider Identifier
1275570459
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
78260 Issued in MA
Practice address
275 Sandwich St.
Jordan Hospital
Plymouth, MA 02360
Phone
(508) 830-2833
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 78260 MA Primary

Addresses

Primary practice location

275 Sandwich St.
Jordan Hospital
Plymouth, MA 02360

Mailing address

24 Shingle Mill LN
Hanover, MA 02339-1312
Phone (508) 830-2833

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
I20080218000451 MA Practitioner - Emergency Medicine 3870676570 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78260MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Oct 1, 2014 Accepting new patients
South Shore Health Express, Inc CurrentSince Sep 1, 2018 Accepting new patients
South Shore Health Express, Inc CurrentSince Sep 1, 2018 Accepting new patients
South Shore Health Express, Inc Current Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Oct 1, 2014 Accepting new patients
Steward Medical Group, Inc PastSince Dec 1, 2015 Accepting new patients

Locations

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

117 Old Church St
Pembroke, MA 02359
Phone (781) 626-5170

59 Long Pond Rd
Plymouth, MA 02360
Phone (781) 626-5180

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

119 Parkingway
Quincy, MA 02169
Phone (781) 626-5160

330 Washington St
Weymouth, MA 02188
Phone (781) 248-8962

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1275570459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SHINGLE MILL LN",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391312",
            "telephone_number": "508-830-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST.",
            "address_2": "JORDAN HOSPITAL",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "02360",
            "telephone_number": "508-830-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICIA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "78260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.