Mark F Sullivan Sr., MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD038772E Issued in PA

Practice address

11236 Robinwood Dr
# 7
Hagerstown, MD 21742-6708

Phone

(301) 665-4760

Fax

(301) 665-4761

NPI assigned

Mar 7, 2006

Sex

Male

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Thoracic SurgeryAlso: General Surgery

Education

Georgetown University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  Care Compare affiliation

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1497722615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E ANTIETAM ST",
            "address_2": "STE 106",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405736",
            "telephone_number": "301-739-6147",
            "fax_number": "301-739-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11236 ROBINWOOD DR",
            "address_2": "# 7",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426708",
            "telephone_number": "301-665-4760",
            "fax_number": "301-665-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARK",
        "middle_name": "F",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD038772E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "11528138",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "348403",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017873640003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msullivan129515@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2000 Foundation Way Ste 3650",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254019197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sufi Acupuncture and Healing
• Casey Seton Sullivan, RN
• Diane Brasher Sullivan, LCSW
• Jacqueline Yvonne Sullivan, CNM
• Luther Boyd Sullivan
• Bradley Sultan
• Jennifer Anne Suminski, CPHT
• Ashton Elizabeth Summers, MS- LCPC
• Tara Denise Summers, OTR/L
• Chakina Sumpter

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.