NPIMap

Individual provider Active NPI

Thomas P Sullivan, M.D.

  • Diagnostic Radiology Physician
  • Bellevue, WA
National Provider Identifier
1649292186
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00034763 Issued in WA
Practice address
1310 116TH Ave NE
Suite E
Bellevue, WA 98004-3817
Phone
(425) 250-1145
Fax
(425) 823-6028
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD213922 OR
Diagnostic Radiology Physician 2085R0202X MD00034763 WA Primary

Addresses

Primary practice location

1310 116TH Ave NE
Suite E
Bellevue, WA 98004-3817

Mailing address

11811 NE 128TH Street
Suite 202
Kirkland, WA 98034
Phone (425) 250-1145

Other practice location 1

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244

Other identifiers 1

IdentifierTypeStateIssuer
8248510MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tsullivan261971@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051220000681 WA Practitioner - Diagnostic Radiology 4082636915 Reassigns benefits to 2 organizations
I20230215001713 OR Practitioner - Diagnostic Radiology 4082636915 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corvallis Radiology PCGroup PAC ID 2062300676, 54 clinicians
Samaritan Pacific Health Services IncGroup PAC ID 2466353529, shared by 7 NPIs, 86 clinicians

Practice addresses (Care Compare)

4570 NE 88TH PL
Seattle, WA 98115-3970
Phone (206) 517-4490

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
85.3
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Apr 1, 2023 Accepting new patients
Radiology Consultants of Washington, Inc., P.S. Diagnostic Radiology CurrentSince Jan 1, 2001 Accepting new patients
Corvallis Radiology PC Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
Radiology Consultants of Washington, Inc., P.S. Diagnostic Radiology Current Accepting new patients

Locations

777 NW 9th St
Ste 210C
Corvallis, OR 97330
Phone (541) 452-8002

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

1310 116th Ave NE
Ste E
Bellevue, WA 98004
Phone (425) 250-1145

3131 Nassau St
#102
Everett, WA 98201
Phone (425) 740-5000

33801 1st Way S
Ste 101
Federal Way, WA 98003
Phone (253) 942-7226

Interoperability endpoints

  • Direct secure messaging: tsullivan261971@samhealth.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 74

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1649292186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 NE 128TH STREET",
            "address_2": "SUITE 202",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-250-1145",
            "fax_number": "425-823-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 116TH AVE NE",
            "address_2": "SUITE E",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043817",
            "telephone_number": "425-250-1145",
            "fax_number": "425-823-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 SW Abbey St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-265-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD213922",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00034763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8248510",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsullivan261971@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.