Patrick M. Sullivan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G20807 Issued in CA

Practice address

145 Palomino Way
Santa Cruz, CA 95060-1475

Phone

(831) 713-5789

NPI assigned

Jun 16, 2011

Last updated

Jun 16, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1558656660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PALOMINO WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601475",
            "telephone_number": "831-713-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PALOMINO WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601475",
            "telephone_number": "831-713-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICK",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G20807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahaana Sudharsan
• Makayla Suits
• Lee Ann Sullivan-Eurs, LMFT
• Carol Sullivan
• Patricia Sullivan, RN
• Peter David Sullivan, M.A., OTR/L
• Richard John Sullivan Jr.
• Ryan Thomas Sullivan, PTA
• Elizabeth Erin Sumner Ballantyne, MFT
• Micah Ece Sunata

• Internal Medicine Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.