Marisa Sullivan, MSN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

431368 Issued in NY

Practice address

301 E 17TH St
New York, NY 10003-3804

Phone

(212) 263-5230

NPI assigned

Feb 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msullivan268787@nyumc.direct-ci.com

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group NPD
• Cooper University Trauma Physicians, PC

  • Trauma Surgery Physician
  • Camden, NJ
  • NPI 1790724730
  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1275991432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET, SUITE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-263-5230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Cooper Plz Rm 518",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031438",
            "country_code": "US",
            "telephone_number": "856-342-3250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARISA",
        "credential": "MSN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00615100",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Tyler Sullivan
• Madonna Sullivan, LMSW
• Margaret Sullivan, NP
• Margaret Ann Sullivan, M.D.
• Maria A. Sullivan, M.D., PH.D.
• Mark Sullivan, M.D.
• Martha Adams Sullivan, DSW
• Matthew Conor Sullivan, PH.D.
• Meg Shannon Sullivan, MD
• Melba J Sullivan, PH.D.

• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.