Individual provider Active NPI

Daniel M Sullivan, DO

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1275792467
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10198 Issued in CA
Practice address
5354 Reynolds St Ste 424
Savannah, GA 31405-6011
Phone
(912) 819-5999
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 20A10198 CA Primary

Addresses

Primary practice location

5354 Reynolds St Ste 424
Savannah, GA 31405-6011

Mailing address

PO Box 15849
Savannah, GA 31416-2549
Phone (912) 819-5999

Other practice location 1

1200 N State St
Ird 628
Los Angeles, CA 90033-1029
Phone (323) 226-7506

Other practice location 2

1200 N State St
Ird 628
Los Angeles, CA 90033-1029
Phone (323) 226-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20090817000527 GA Practitioner - Internal Medicine 2860546462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chatham Hosptialists, LLCGroup PAC ID 1456456995, 33 clinicians

Practice addresses (Care Compare)

5354 Reynolds St
Suite 424
Savannah, GA 31405-6011
Phone (912) 819-5999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10198CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chatham Hosptialists, LLC Internal Medicine CurrentSince Aug 1, 2009 Accepting new patients
Saint Joseph'S Hospital, Inc. Past Accepting new patients

Locations

5354 Reynolds St
Ste 424
Savannah, GA 31405
Phone (912) 819-5999

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.

Hospital & facility affiliations 3

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275792467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15849",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162549",
            "telephone_number": "912-819-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS ST STE 424",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056011",
            "telephone_number": "912-819-5999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "IRD 628",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-226-7506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N State St",
            "address_2": "IRD 628",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-226-7506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.