Active NPI
Pamela Ninoska Sullivan, SA-C
- Surgical Assistant
- Olney, MD
National Provider Identifier
1538948260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 23-587
- Practice address
- 3570 Olney Laytonsville Rd
Olney, MD 20830-7581 - Phone
- (301) 637-8414
- NPI assigned
- Sep 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 23-587 | MD | Primary |
Addresses
Primary practice location
3570 Olney Laytonsville Rd
Olney, MD 20830-7581
Mailing address
1604 Dayton Rd
Hyattsville, MD 20783-3022
Phone (240) 564-3356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-587 | MD | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1538948260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 DAYTON RD",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207833022",
"telephone_number": "240-564-3356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 OLNEY LAYTONSVILLE RD",
"city": "OLNEY",
"state": "MD",
"postal_code": "208307581",
"telephone_number": "301-637-8414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "PAMELA",
"middle_name": "NINOSKA",
"credential": "SA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-22",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "MD",
"license": "23-587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.