Individual provider Active NPI

Erin Sullivan, NP

  • Family Nurse Practitioner
  • Marina, CA
National Provider Identifier
1396142014
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001703 Issued in CA
Practice address
2930 2ND Ave Ste 120
Marina, CA 93933-6244
Phone
(831) 622-6935
NPI assigned
Nov 24, 2014
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001703 CA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200103001881 CA Practitioner - Nurse Practitioner 3779917489 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mogo Urgent CareGroup PAC ID 7810329976, 21 clinicians

Practice addresses (Care Compare)

2020 Del Monte Ave
Suite B
Monterey, CA 93940-2401
Phone (831) 625-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95001703CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Medical Care of California CurrentSince Sep 5, 2024 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Oct 16, 2019 Accepting new patients
Mogo Urgent Care CurrentSince Sep 1, 2024 Accepting new patients
Mogo Urgent Care CurrentSince Dec 16, 2019 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Oct 16, 2019 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1396142014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "AROMAS",
            "state": "CA",
            "postal_code": "950040211",
            "telephone_number": "831-277-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 2ND AVE STE 120",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336244",
            "telephone_number": "831-622-6935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 1st St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941052661",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.