Sean Tyler O'Sullivan, DO
Individual provider Active NPI Family Medicine Physician · Scarborough, ME
NPI 1285073205 · NPPES record last updated Sep 28, 2020
Key facts
- NPI
- 1285073205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO2641 (ME)
- Practice address
- 153 US Route 1
Scarborough, ME 04074-9052 - Phone
- (207) 799-8596
- NPI assigned
- Jun 24, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 40
Medicare Care Compare profile
- 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.
Central Maine Medical Center
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
- Bayada Home Health Care Inc
- Mainehealth Maine Medical Center
- Northern Light Mercy Hospital
- Central Maine Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170721001966 | ME | Practitioner - Family Practice | 1153544374 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2641 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Maine Medical Partners | Current |
Accepting new patients | |
| Maine Medical Partners | Family Medicine | Current |
Accepting new patients |
| Central Maine Medical Center | Current |
Accepting new patients | |
| Mainehealth | Current |
Accepting new patients | |
| Mainehealth | Current |
Accepting new patients | |
| Central Maine Medical Center | Current |
Accepting new patients | |
| Mainehealth | Family Medicine | Current |
Accepting new patients |
| Martin'S Point Health Care, Inc. | Family Medicine | Current |
Accepting new patients |
| Central Maine Medical Center | Past | Accepting new patients |
Locations
76 High St
Fl 1
Lewiston, ME 04240
Phone (207) 795-2800
300 Main St
Lewiston, ME 04240
Phone (207) 795-2400
76 High St
Lewiston, ME 04240
Phone (207) 795-2800
331 Veranda St
Portland, ME 04103
Phone (207) 774-5801
5 Bucknam Rd
Portland, ME 04105
Phone (207) 781-1500
272 Congress St
Portland, ME 04101
Phone (207) 874-2466
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
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
- https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
- https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO2641 | ME | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sean.o.sullivan.1@5857.direct.athenahealth.com |
Other providers in Scarborough, ME
- NR Maine, LLC
- Nicole O'Brien
- Colleen M O'Connor
- Kimberly Anne O'Dell
- Tatyana Elaine O'Donnell
- Maura Oakes
- Oasis Management Services
- Peter Tioseco Ocampo
- Office of Henry Blanchette Pmhnp LLC
- John Richard Ogorek
All providers in Scarborough, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.