Andrew Sullivan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

291552 Issued in CA

Practice address

6041 Cadillac Ave
Los Angeles, CA 90034-1702

Phone

(323) 857-2000

NPI assigned

Jul 31, 2015

Last updated

Feb 19, 2017By the provider in NPPES

Sex

Male

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 CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ptsma, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Pawcatuck, CT
  • NPI 1033773759

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Madison Rehabilitation Center Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Madison, CT
  • NPI 1750350245

  Physical Therapist

  Medicare reassignment NPD
• Ptsma Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Manchester, CT
  • NPI 1619393337
  NPD
• Ptsma, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Newington, CT
  • NPI 1508322272

  Physical Therapist

  NPD

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487462400000",
    "number": "1497131445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 14TH ST",
            "address_2": "APT 103",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702",
            "telephone_number": "323-857-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-31",
        "last_updated": "2017-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14.010583",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Siddig Sulieman, M.D.
• Michael Jay Paulino Sulit
• Ashley Sullens
• Veronica Sullins, MD
• Hanorah Sullivan-Houndalas, L.AC., DIPL. AC.
• Angela Marie Sullivan, M.S.
• Asia Jasmine Sullivan, PA-C
• Corissa Dante' Sullivan
• Hannah Leigh Sullivan
• Joshua Patrick Sullivan, LCSW

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.