Len Sullivan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11712 Issued in TX

Practice address

305 Mallard LN
Taylor, TX 76574-1208

Phone

(512) 352-7611

Fax

(512) 352-2196

NPI assigned

Jan 12, 2007

Last updated

Nov 1, 2023By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, TX, NM3 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 3

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brazos Emergency Medicine Associates PAGroup PAC ID 3274005103, 12 clinicians

Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment Care Compare group NPD
• Dimmit Regional Hospital

  • Critical Access Hospital
  • Carrizo Springs, TX
  • NPI 1326134255
  Medicare reassignment NPD
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Nurse Practitioner
  • Taylor, TX
  • NPI 1659548568

  Physician Assistant

  Medicare reassignment NPD
• Neighborhood Health, Inc.

  dba HHC Neighborhood Health

  • General Practice Physician
  • Torrington, CT
  • NPI 1043544489

  Physician Assistant

  Medicare reassignment NPD
• Nes Arizona Inc

  • Emergency Medicine Physician
  • Fort Mohave, AZ
  • NPI 1285163121

  NM

  Medicare reassignment NPD
• St. Vincents Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fairfield, CT
  • NPI 1912305483

  Physician Assistant

  Medicare reassignment NPD
• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment
• Dimmit Regional Hospital

  • Emergency Medicine Physician
  • Carrizo Springs, TX
  • NPI 1164774253
  Medicare reassignment
• Emergency Associates of Central Texas PA

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1215418280
  Medicare reassignment
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment
• Lake Granbury Hospital-Based Professional Services

  • Emergency Medicine Physician
  • Granbury, TX
  • NPI 1689443467
  Medicare reassignment
• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1649669672
  Medicare reassignment

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

• Presbyterian Healthcare Services

  dba Plains Regional Medical Center

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  Care Compare affiliation

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1326198110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-7611",
            "fax_number": "512-352-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Rte 75 AASF Bldge 154",
            "address_purpose": "LOCATION",
            "city": "Windsor Locks",
            "state": "CT",
            "postal_code": "06096",
            "country_code": "US",
            "telephone_number": "860-292-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "00703",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "902",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Janella Spalding, M.S., CCC-SLP
• Diana L Stone, D.O.
• Jason Christopher Stone, OD
• Mark A. Stone, M.D.
• Sufiyana Counseling Services PLLC
• Yumnah Syed-Swift, LCSW
• Takii Family Dentistry PLLC
• Isao Francisco Takii, DDS
• Taylor Care Center
• Taylor Choice Dental

• Physician Assistant in Taylor, TX
• Providers in Taylor, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.