Kathleen Marie Sullivan, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN2259252 Issued in MA

Practice address

830 Harrison Ave
Moakley, 2ND Floor
Boston, MA 02118-2905

Phone

(617) 638-6525

Fax

(617) 638-7448

NPI assigned

Dec 12, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035
• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
• Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sullivan.kathleen.mgh@direct.partners.masshiway.net

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.

• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment Care Compare group NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment Care Compare group
• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • General Acute Care Hospital
  • Northampton, MA
  • NPI 1477596310
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • Psychiatric Hospital Unit
  • Northampton, MA
  • NPI 1871512814
  Care Compare affiliation
• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1376811828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "MOAKLEY, 2ND FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-6525",
            "fax_number": "617-638-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2259252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110091798A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Gwenhwyvar Sullivan
• John Michael Sullivan, PA-C
• Judith Sullivan, NP
• Kaitlyn Sullivan
• Kathleen Sullivan, PHARM.D., RPH
• Kathleen Ruth Sullivan, C.N.M.
• Kathryn Sullivan
• Keri J Sullivan, RN, MS, CPNP
• Kristin Marie Sullivan, PA-C
• Lara Sullivan, LICSW

• Adult Health Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.