Josephine Elisabeth Sullivan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

051015 Issued in NY

Practice address

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Phone

(718) 918-3060

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsullivan838893@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Bronx, NY
  • NPI 1003824608
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467518191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 W HARTSDALE RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106071815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOSEPHINE",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02611723",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Hope Sullivan, LMSW
• Daniel James Sullivan, DPM
• Denise Luise Sullivan, APRN
• Erin Kathleen Sullivan, OTR/L
• Jacqueline Gloria Sullivan, PA
• Judith Ann Sullivan, LPN
• Kathryn Sullivan, PA-C
• Kevin John Sullivan, PHARM.D.
• Loretta Sullivan, NP
• Margaret Rose Sullivan, PA-C

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.