Danielle Aysha Sultan, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1018304 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 421-1400

Fax

(508) 421-1490

NPI assigned

Apr 29, 2020

Last updated

May 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MA

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

Emergency Medicine

Education

University of New England, College of Osteo Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• U-Mass Memorial Health Care Systems Dialysis facility, Worcester, MA, CCN 222316
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Marlborough Hospital Hospital, Marlborough, MA, CCN 220049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

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

• Marlborough Hospital Corp

  dba Marlborough Hospital

  • Registered Dietitian
  • Marlborough, MA
  • NPI 1104488170

  Hospital

  Care Compare affiliation Name & address match
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1457972614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036202",
            "country_code": "US",
            "telephone_number": "610-402-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULTAN",
        "first_name": "DANIELLE",
        "middle_name": "AYSHA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1018304",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT019869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Lynn Sullivan
• Rachel R Sullivan
• Ryan Delano Sullivan, MD
• Shawna Sullivan, OTR/L
• Ivelisse Sully
• Khaled A. Sultani
• Stephen Mark Summers, M.D.
• Summit Academy, Inc.
• Summit Psychiatry
• Concetta Marie Sumner

• Emergency Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.