Active NPI
Catherine Elizabeth Sullivan
- Psychiatry Physician
- Cambridge, MA
National Provider Identifier
1427375104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 257910
- Practice address
- 10 Concord Ave
Cambridge, MA 02138-2322 - Phone
- (617) 299-9286
- NPI assigned
- Apr 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 257910 | MA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
10 Concord Ave
Cambridge, MA 02138-2322
Mailing address
10 Concord Ave
Cambridge, MA 02138-2322
Phone (617) 299-9286
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 24, 2022 through Sep 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 257910 | MA | MD | Psychiatry Physician |
| 117741 | CA | MD | Nuclear Medicine Technology Radiologic Technologist |
Interoperability endpoints
- lifestancehealth.catherinesullivan@148377.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1427375104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021382322",
"telephone_number": "617-299-9286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021382322",
"telephone_number": "617-299-9286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CATHERINE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-21",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "257910",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.