Malin Sullivan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

20730 Issued in CA

Practice address

225 N Jackson Ave
San Jose, CA 95116-1603

Phone

(408) 259-5000

NPI assigned

Jan 20, 2010

Last updated

Jan 20, 2010By the provider in NPPES

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1518298249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DEL VALLE",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950039506",
            "telephone_number": "831-430-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-259-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MALIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jani K Sullivan, MS
• John Sullivan, M.D.
• Leslie A Sullivan, M.D.
• Lisa Sullivan, M.A. LMFT
• Madelyn Sullivan
• Moira Sullivan, MS, OTR/L
• Nora Sullivan
• Patti Sullivan, MFT
• Raymond Lawrence Sullivan Jr., MD
• Susan Ann Sullivan, M.S.

• Physician Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.