Mary M Osullivan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT005952L Issued in PA

Practice address

190 W Sproul Rd
Springfield, PA 19064-2027

Phone

(610) 338-2796

Fax

(610) 338-2797

NPI assigned

Mar 2, 2021

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

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shannondell, Inc.Group PAC ID 9032141189, 19 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.

• Shannondell, Inc.

  dba Rehab at Shannondell

  • Skilled Nursing Facility
  • Audubon, PA
  • NPI 1922056076
  Medicare reassignment Care Compare group NPD
• Shannondell Inc.

  dba Rehab at Shannondell

  • Physical Therapy Clinic/Center
  • Audubon, PA
  • NPI 1972982247
  NPD
• Shannondell, Inc.

  dba Shannondell Medical Group

  • Primary Care Clinic/Center
  • Audubon, PA
  • NPI 1225825342
  NPD
• Shannondell, Inc.

  dba Shannondell Health

  • Geriatric Medicine (Internal Medicine) Physician
  • Audubon, PA
  • NPI 1043927338
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1508451576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 E VALLEY FORGE RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062032",
            "telephone_number": "610-322-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W SPROUL RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642027",
            "telephone_number": "610-338-2796",
            "fax_number": "610-338-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSULLIVAN",
        "first_name": "MARY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT005952L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olive Care Services LLC
• Dana J Olive, PHD, CRNP
• Anna Opalko, MPH, RD
• Optum Behavioral Care of Connecticut, P.C.
• Max Oran
• Shormeh Yeboah Otsin, MD
• Emilie R Owens, FNP-BC
• Gloria Owusu-Boachie, RN
• PA Center for Hearing and Balance, LLC
• Pace Foot and Ankle Centers PLLC

• Physical Therapist in Springfield, PA
• Providers in Springfield, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.