Erin Sullivan, NP
Individual provider Active NPI Family Nurse Practitioner · Marina, CA
NPI 1396142014 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1396142014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95001703 (CA)
- Practice address
- 2930 2ND Ave Ste 120
Marina, CA 93933-6244 - Phone
- (831) 622-6935
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mogo Urgent Care
Practice addresses (Care Compare)
2020 Del Monte Ave
Suite B
Monterey, CA 93940-2401
Phone (831) 625-4500
Hospital & facility affiliations
- Community Hospital of the Monterey Peninsula
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200103001881 | CA | Practitioner - Nurse Practitioner | 3779917489 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95001703 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital of the Monterey Peninsula | Current |
Accepting new patients | |
| Mogo Urgent Care | Current |
Accepting new patients | |
| Circle Medical Care of California | Current |
Accepting new patients | |
| Community Hospital of the Monterey Peninsula | Current |
Accepting new patients | |
| Mogo Urgent Care | Current |
Accepting new patients |
Locations
415 N Crescent Dr
Ste 320
Beverly Hills, CA 90210
Phone (415) 510-2755
2930 2nd Ave
Ste 120
Marina, CA 93933
Phone (831) 622-6935
2020 Del Monte Ave
Ste B
Monterey, CA 93940
Phone (831) 622-6930
23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708
333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95001703 | CA | Yes |
Addresses
Primary practice location
2930 2ND Ave Ste 120
Marina, CA 93933-6244
Mailing address
PO Box 211
Aromas, CA 95004-0211
Phone (831) 277-6168
Other practice location 1
333 1st St Ste A
San Francisco, CA 94105-2661
Phone (888) 803-3370
Other providers in Marina, CA
- Albert M Sterwerf
- Samantha Straskulic
- Qing Su
- Lois Suh
- Charles Bret Sullivan
- Suzie Sullivan
- Sun Street Centers
- Amanda Swift
- Amy Thistle Tackett
- Momoko Takeda
All providers in Marina, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.