John L Sullivan, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C50000356 Issued in DE

Practice address

540 S Governors Ave
Suite 101a
Dover, DE 19904-3530

Phone

(302) 744-7980

Fax

(302) 744-7989

NPI assigned

Jan 10, 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

Medicare fee-for-service enrollment

Enrolled in DE

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

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 and National Provider Directory roles.

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Medicare reassignment NPD
• Bayhealth Medical Center, Inc.

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1679072144
  Medicare reassignment NPD
• Bayhealth Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1073012696
  Medicare reassignment
• Bayhealth Medical Center, Inc

  • Gastroenterology Physician
  • Milford, DE
  • NPI 1639938525
  NPD
• Surgical Associates PA

  • Surgery Physician
  • Dover, DE
  • NPI 1538115829
  NPD
• Sussex Emergency Associates LLC

  • Emergency Medicine Physician
  • Lewes, DE
  • NPI 1275512105
  NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1548249477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "address_2": "FINANCE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-4700",
            "fax_number": "302-735-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S GOVERNORS AVE",
            "address_2": "SUITE 101A",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043530",
            "telephone_number": "302-744-7980",
            "fax_number": "302-744-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50000356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B. Suh, M.D.
• Donald D. Suh, M.D.
• Alyssa Suhr
• Destiny Suitt
• Venkataraman R Sukumar, M.D.
• Leah Denise Sullivan, LCSW
• Sunbird Counseling & Consulting LLC
• Danielle Sunga
• Sunshine Health Professionals
• Support Innovative Projects LLC

• Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.