Reid Kathleen Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0009794 Issued in MD

Practice address

7704 Matapeake Business Dr Ste 200
Brandywine, MD 20613-3045

Phone

(301) 812-3900

NPI assigned

Feb 20, 2025

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

Enrolled in DC

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 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maryland Oncology Hematology PAGroup PAC ID 2062302102, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Charles Regional Medical Center Hospital, La Plata, MD, CCN 210035

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: reid.sullivan@mdonc.ikm.direct-ci.com

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.

• Maryland Oncology Hematology, P.a.

  • Multi-Specialty Clinic/Center
  • Laurel, MD
  • NPI 1821271032

  DC

  Medicare reassignment Care Compare group
• Maryland Oncology Hematology P.a.

  • Hematology & Oncology Physician
  • Columbia, MD
  • NPI 1396710703
  NPD

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

• Civista Medical Center Inc

  • Rural Acute Care Hospital
  • La Plata, MD
  • NPI 1992701825
  Care Compare affiliation
• Civista Medical Center, Inc.

  • Physical Therapist
  • La Plata, MD
  • NPI 1689071219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1376349399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7704 MATAPEAKE BUSINESS DR STE 200",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133045",
            "telephone_number": "301-812-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7704 MATAPEAKE BUSINESS DR STE 200",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133045",
            "telephone_number": "301-812-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 Healthcare Way Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "MD",
            "postal_code": "207745484",
            "country_code": "US",
            "telephone_number": "301-812-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REID",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Leia Swanson
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• Bella Javis Tandungang

• Physician Assistant in Brandywine, MD
• Providers in Brandywine, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.