Individual provider Active NPI

Matthew Scott Sullivan, MD

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1669868618
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.097025 Issued in OH
Practice address
3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937
Phone
(614) 255-6900
Fax
(614) 255-6901
NPI assigned
Apr 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35.097025 OH Primary

Addresses

Primary practice location

3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937

Mailing address

3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937
Phone (614) 255-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009002330 OH Practitioner - Internal Medicine 8820307325

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Dave Cowens Dr
Suite 600
Newport, KY 41071-4563

PO Box
Suite 904
Lima, OH 45802-0904

PO Box
Suite 935
Lima, OH 45802-0935

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Past Accepting new patients

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1669868618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 OLENTANGY RIVER RD STE 4330",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143937",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 OLENTANGY RIVER RD STE 4330",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143937",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.097025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.