Kathy M Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA002986L Issued in PA

Practice address

300 State St
#400A
Erie, PA 16507-1427

Phone

(814) 454-8287

Fax

(814) 454-8470

NPI assigned

Dec 12, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Orthopaedic & Sports Medicine of Erie, PC

  • Orthopaedic Surgery Physician
  • Erie, PA
  • NPI 1760444624
  NPD

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326023433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STATE ST",
            "address_2": "#400A",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071427",
            "telephone_number": "814-454-8287",
            "fax_number": "814-454-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST",
            "address_2": "#400A",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071427",
            "telephone_number": "814-454-8287",
            "fax_number": "814-454-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002986L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean C Su, MD
• Kevin Subers, MSW
• Subramanyam Segu, MD, Inc
• Melissa Marie Sulkowski, M.A.
• Charles Edward Sullivan, PHARMD
• Nathan Sullivan, LSW
• Dalton Wade Summerhill
• Miranda Renee Summers, MS OTR/L
• Summit Dental Associates, P. C
• Summit Footwear, LLC

• Physician Assistant in Erie, PA
• Providers in Erie, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.