Patricia Leigh Zadnik Sullivan, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD17697 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 793-9166

NPI assigned

Jun 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Specialty

Neurosurgery

Education

Johns Hopkins University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhode Island Hospital Hospital, Providence, RI, CCN 410007
• The Miriam Hospital Hospital, Providence, RI, CCN 410012
• Newport Hospital Hospital, Newport, RI, CCN 410006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

• Newport Hospital

  • General Acute Care Hospital
  • Newport, RI
  • NPI 1457346413
  Care Compare affiliation
• Rhode Island Hospital

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1447664792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-793-9166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "800-789-7366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICIA",
        "middle_name": "LEIGH ZADNIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-15",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT206876",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "RI",
            "license": "MD17697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Lynn Sullivan, PHD
• Kevin Sullivan, RN
• Madison Sullivan
• Mallory Sullivan, PA
• Mary A Sullivan, PCNS
• Patrick Sullivan, MD
• Patrick B. Sullivan, M.D.
• Rachel Aileen Sullivan, MD
• Rachel R Sullivan
• Shannon Sullivan, LCSW

• Neurological Surgery Physician in Providence, RI
• Providers in Providence, RI by specialty
• Neurological Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.