Individual provider Active NPI

Ryan J Sullivan, M.D.

  • Emergency Medicine Physician
  • Weymouth, MA
National Provider Identifier
1477873412
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
254184 Issued in MA
Practice address
55 Fogg Road
Weymouth, MA 02190
Phone
(781) 624-8000
Fax
(781) 878-6750
NPI assigned
Jun 1, 2010
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 254184 MA Primary

Addresses

Primary practice location

55 Fogg Road
Weymouth, MA 02190

Mailing address

55 Fogg Road
Weymouth, MA 02190
Phone (781) 624-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130917000016 MA Practitioner - Emergency Medicine 1355585290 Reassigns benefits to 3 organizations
I20240313000547 NH Practitioner - Emergency Medicine 1355585290 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians
Brockton Hospital, Inc.Group PAC ID 4082504733, 36 clinicians

Practice addresses (Care Compare)

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
254184MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weeks Medical Center CurrentSince Jan 17, 2024 Accepting new patients
Brockton Hospital, Inc. CurrentSince Apr 21, 2025 Accepting new patients
Brockton Hospital, Inc. CurrentSince Apr 21, 2025 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Jan 17, 2024 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Jan 17, 2024 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Apr 21, 2025 Accepting new patients
Weeks Medical Center Current Accepting new patients
Weeks Medical Center CurrentSince Jan 17, 2024 Accepting new patients
Androscoggin Valley Hospital Inc CurrentSince Jan 17, 2024 Accepting new patients
Upper Connecticut Valley Hospital Association CurrentSince Feb 1, 2024 Accepting new patients
Coastal Medical Associates CurrentSince Jul 1, 2017 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

7 Page Hill Rd
Berlin, NH 03570
Phone (603) 326-5827

181 Corliss Ln
Colebrook, NH 03576
Phone (603) 237-8652

173 Middle St
Lancaster, NH 03584
Phone (603) 788-4911

Interoperability endpoints

  • Direct secure messaging: ryan.sullivan@direct.signature.masshiway.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1477873412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FOGG ROAD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-8000",
            "fax_number": "781-878-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG ROAD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-8000",
            "fax_number": "781-878-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "254184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.