NPIMap

Individual provider Active NPI

Sean Tyler O'Sullivan, DO

  • Family Medicine Physician
  • Scarborough, ME
National Provider Identifier
1285073205
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2641 Issued in ME
Practice address
153 US Route 1
Scarborough, ME 04074-9052
Phone
(207) 799-8596
NPI assigned
Jun 24, 2013
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO2641 ME Primary

Addresses

Primary practice location

153 US Route 1
Scarborough, ME 04074-9052

Mailing address

PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sean.o.sullivan.1@5857.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170721001966 ME Practitioner - Family Practice 1153544374 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

153 US Route 1
Scarborough, ME 04074-9052
Phone (207) 799-8596

76 High St
FL 1
Lewiston, ME 04240-7649
Phone (207) 795-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2641MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 1, 2018 Accepting new patients
Central Maine Medical Center CurrentSince Dec 18, 2019 Accepting new patients
Maine Medical Partners CurrentSince Aug 19, 2020 Accepting new patients
Martin's Point Health Care, Inc. Family Medicine CurrentSince Jul 31, 2017 Accepting new patients
Maine Medical Partners Family Medicine CurrentSince Aug 19, 2020 Accepting new patients
Mainehealth Family Medicine CurrentSince Mar 1, 2018 Accepting new patients
Mainehealth CurrentSince Mar 1, 2018 Accepting new patients
Central Maine Medical Center CurrentSince Dec 18, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Central Maine Medical Center Past Accepting new patients

Locations

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

76 High St
Lewiston, ME 04240
Phone (207) 795-2800

76 High St
Fl 1
Lewiston, ME 04240
Phone (207) 795-2800

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

272 Congress St
Portland, ME 04101
Phone (207) 874-2466

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

5 Bucknam Rd
Portland, ME 04105
Phone (207) 781-1500

153 US Route 1
Scarborough, ME 04074
Phone (207) 799-8596

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: sean.o.sullivan.1@5857.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1285073205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749052",
            "telephone_number": "207-799-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "SEAN",
        "middle_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sean.o.sullivan.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "153 US Route 1",
            "city": "Scarborough",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040749052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.