Mark Allen Sullivan, MBA, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

003846 Issued in CT

Practice address

133 Mountain Rd
Suite 2B.
Suffield, CT 06078-2084

Phone

(860) 254-5982

NPI assigned

Jun 29, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

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.

• Innovative Physician Services LLC

  • Physical Medicine & Rehabilitation Physician
  • Springfield, MA
  • NPI 1922096049

  Physical Therapist

  NPD
• Advantage Physical Therapy and Sports Medicine, LLC

  • Physical Therapy Clinic/Center
  • Windsor, CT
  • NPI 1013082817

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1306874227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HEARTHSTONE DR",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010013238",
            "telephone_number": "413-789-2168",
            "fax_number": "860-254-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MOUNTAIN RD",
            "address_2": "SUITE 2B.",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782084",
            "telephone_number": "860-254-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MBA, PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "003846",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CT",
            "license": "003846",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "003846",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suffield Pediatric and Adolescent Medicine PLLC
• Suffield Psychology Associates
• Suffield SNF Operations LLC
• Suffield Village Dental
• Suffield Volunteer Ambulance Association Inc
• Alea Tardy
• Jacqueline Testa, LPC
• Therigatha Center for Psychotherapy
• Craig McClain Tini, DDS
• Kathryn Mary Tkacz, LMFT

• Physical Therapist in Suffield, CT
• Providers in Suffield, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.