Individual provider Active NPI

Brenda Lee Sullivan, M.D.

  • Internal Medicine Physician
  • Yonkers, NY
National Provider Identifier
1275712580
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
168673 Issued in NY
Practice address
955 Yonkers Ave
Suite 110
Yonkers, NY 10704-3060
Phone
(914) 237-1260
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 168673 NY Primary

Addresses

Primary practice location

955 Yonkers Ave
Suite 110
Yonkers, NY 10704-3060

Mailing address

955 Yonkers Ave
Suite 110
Yonkers, NY 10704-3060
Phone (914) 237-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120420000585 NY Practitioner - Internal Medicine 2365603180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

171 Huguenot St
New Rochelle, NY 10801-7760
Phone (914) 607-5800

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

Hospital & facility affiliations

  • Archcare at Home Home health agency, Valhalla, NY, CCN 337140
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304
  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168673NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Group, P.C. Internal Medicine CurrentSince Jul 15, 2012 Accepting new patients
The Westchester Medical Group PC CurrentSince Jul 15, 2012 Accepting new patients
Greater Rockland Surgical PC Past Accepting new patients

Locations

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

955 Yonkers Ave
Ste 100
Yonkers, NY 10704
Phone (914) 237-2002

955 Yonkers Ave
Ste 110
Yonkers, NY 10704
Phone (718) 365-7255

73 Market St
Yonkers, NY 10710
Phone (914) 848-8030

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: brenda.sullivan.1@21260.direct.athenahealth.com
  • Direct secure messaging: bsullivan@hiemail.healtheconnections.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1275712580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 YONKERS AVE",
            "address_2": "SUITE 110",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043060",
            "telephone_number": "914-237-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 YONKERS AVE",
            "address_2": "SUITE 110",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043060",
            "telephone_number": "914-237-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "168673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.