Active NPI
Karli Sullivan, PA
- Surgical Physician Assistant
- Portland, ME
National Provider Identifier
1679259014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA2826
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-2934
- Fax
- (207) 662-6389
- NPI assigned
- Jun 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA2826 | ME | Primary |
| Surgical Physician Assistant | 363AS0400X | 25MP00790300 | NJ | |
| Physician Assistant | 363A00000X | PA2826 | ME |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2934
Other practice location 1
1 Capital Way Ste 390
Pennington, NJ 08534-2520
Phone (732) 426-3420
Other practice location 2
887 Congress St Ste 400
Portland, ME 04102-3163
Phone (207) 774-6368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| The Woods O.R., Inc. | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368
Interoperability endpoints
- krymer916541@direct.mmc.mainehealth.org
Organizations & group practices 5
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Plastic and Reconstructive Surgery Physician
- Red Bank, NJ
- NPI 1386613834
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Clinic/Center
- Portland, ME
- NPI 1487346722
-
- Ambulatory Surgical Clinic/Center
- Tinton Falls, NJ
- NPI 1952610768
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1679259014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2934",
"fax_number": "207-662-6389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2934",
"fax_number": "207-662-6389"
}
],
"practiceLocations": [
{
"address_1": "1 Capital Way Ste 390",
"address_purpose": "LOCATION",
"city": "Pennington",
"state": "NJ",
"postal_code": "085342520",
"country_code": "US",
"telephone_number": "732-426-3420",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "887 Congress St Ste 400",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041023163",
"country_code": "US",
"telephone_number": "207-774-6368",
"fax_number": "207-774-9388",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KARLI",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-22",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "ME",
"license": "PA2826",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00790300",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "PA2826",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.