Kathleen Connelly Sullivan, MS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AP2616 Issued in MA

Practice address

2 Fogg Rd
Weymouth, MA 02190

Phone

(781) 624-8000

NPI assigned

Oct 1, 2008

Sex

Female

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

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard G Abood, M.D., P.a.Group PAC ID 2567403215, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

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.

• Richard G Abood, M.D., P.a.

  • General Practice Physician
  • Naples, FL
  • NPI 1265455182
  Medicare reassignment Care Compare group
• Southwest Florida Emergency Management LLC

  • Emergency Medicine Physician
  • Naples, FL
  • NPI 1780911206
  Medicare reassignment
• Thse - Marco Urgent Care LLC

  • Internal Medicine Physician
  • Marco Island, FL
  • NPI 1801125331
  Medicare reassignment

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1639320336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DOVER CIR",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "020381548",
            "telephone_number": "508-212-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHLEEN",
        "middle_name": "CONNELLY",
        "name_prefix": "Ms.",
        "credential": "MS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "AP2616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Nicole Sullivan, BA
• Elana Sullivan, M.D.
• Jessica Jeanne Sullivan, NP
• Joyce M Sullivan, OTR
• Julie Armstrong Sullivan, SLP
• Maria Catherine Sullivan
• Ryan J Sullivan, M.D.
• Sean Sullivan, RN
• Richard Dong Sun, MD
• Kristin M Sunkin, M.A.

• Physician Assistant in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.