Individual provider Active NPI

Brett S Sullivan, M.D.

  • Anesthesiology Physician
  • Pensacola, FL
National Provider Identifier
1356385405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME79310 Issued in FL
Practice address
1000 W Moreno St
Pensacola, FL 32501-2316
Phone
(850) 437-8390
Fax
(850) 437-8394
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME79310 FL Primary

Addresses

Primary practice location

1000 W Moreno St
Pensacola, FL 32501-2316

Mailing address

PO Box 10824
Birmingham, AL 35202-0824
Phone (205) 322-1808

Other identifiers 4

IdentifierTypeStateIssuer
49350OtherFLBCBS
59169959OtherALBCBS
P00134517OtherPALMETTO GBA-RR MEDICARE
59169956OtherALBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000926 FL Practitioner - Anesthesiology 6406832658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Baptist LLCGroup PAC ID 6901099688, 80 clinicians
Florida Gulf Coast Anesthesia LLCGroup PAC ID 8224458518, 2 clinicians

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-8478

4724 N Davis Hwy
Pensacola, FL 32503-2339
Phone (850) 696-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Baptist LLC Anesthesiology CurrentSince Oct 1, 2010 Accepting new patients
Florida Gulf Coast Anesthesia, LLC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
Ams of Gulf Breeze LLC Anesthesiology CurrentSince Feb 1, 2012 Accepting new patients
The Anesthesia Group, P.a. Anesthesiology Past Accepting new patients
Anesthesia Health Care Partners of Florida Inc Anesthesiology Past Accepting new patients

Locations

4724 N Davis Hwy
Pensacola, FL 32503
Phone (850) 444-4716

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356385405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10824",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352020824",
            "telephone_number": "205-322-1808",
            "fax_number": "205-322-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W MORENO ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325012316",
            "telephone_number": "850-437-8390",
            "fax_number": "850-437-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRETT",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME79310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49350",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59169959",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "P00134517",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59169956",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.