Elizabeth A Sullivan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

281207 Issued in NY

Practice address

119 Woodbury Rd
Huntington, NY 11743-4135

Phone

(631) 546-8953

Fax

(631) 423-1514

NPI assigned

Apr 21, 2010

Sex

Female

Sole proprietor

Yes

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
  • NPI 1104096049
  Medicare reassignment NPD
• Direct House Medical PLLC

  • Surgery Physician
  • Huntington, NY
  • NPI 1790143386
  NPD
• Southwest Suffolk Medical PC

  • Family Medicine Physician
  • Lindenhurst, NY
  • NPI 1770919763
  NPD

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1407173172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WOODBURY RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434135",
            "telephone_number": "631-546-8953",
            "fax_number": "631-423-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WOODBURY RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434135",
            "telephone_number": "631-546-8953",
            "fax_number": "631-423-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "281207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kareem Abdul Strong
• Eric Scott Studley, D.D.S.
• Laura Rima Suer, RN
• Suffolk Behavioral Health
• Elizabeth Sullivan
• Maureen N Sullivan, P.T.
• Susan Sullivan, NP
• Sun River Health Inc
• George Surguladze
• Surya Wellness Massage Therapy PLLC

• Family Medicine Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.