NPIMap

Individual provider Active NPI

Kathryn Elizabeth Sullivan

  • Physician Assistant
  • Boulder, CO
National Provider Identifier
1518758689
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5556 Spine Rd Unit 305
Boulder, CO 80301-3585
Phone
(401) 258-4381
NPI assigned
May 16, 2025
Last updated
May 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

5556 Spine Rd Unit 305
Boulder, CO 80301-3585

Mailing address

5556 Spine Rd Unit 305
Boulder, CO 80301-3585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024002276 CO Practitioner - Physician Assistant 7810485331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bouldercentre for Orthopedics PCGroup PAC ID 3971409020, 56 clinicians

Practice addresses (Care Compare)

4740 Pearl Pkwy
Suite 200
Boulder, CO 80301-3080
Phone (303) 449-2730

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bouldercentre for Orthopedics PC CurrentSince Oct 6, 2025 Accepting new patients
Bouldercentre for Orthopedics CurrentSince Oct 6, 2025 Accepting new patients

Locations

4740 Pearl Pkwy
Ste 200
Boulder, CO 80301

1185 State Highway 7
Ste 200
Broomfield, CO 80023

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3497/brand/1/csg/21/fhir/r4
  • Direct secure messaging: katie.sullivan.1@3497.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1518758689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5556 SPINE RD UNIT 305",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 SPINE RD UNIT 305",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013585",
            "telephone_number": "401-258-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.