Eric M Sullivan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD161287 Issued in OR

Practice address

920 Country Club Rd
Suite 200a
Eugene, OR 97401-6024

Phone

(541) 342-2134

Fax

(541) 684-3074

NPI assigned

Sep 20, 2006

Last updated

Sep 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

University of Colorado School of Medicine, Denver, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samg Inc

  • Primary Care Clinic/Center
  • Plymouth Meeting, PA
  • NPI 1760103881
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1689771636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-342-2134",
            "fax_number": "541-684-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 COUNTRY CLUB RD",
            "address_2": "SUITE 200A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016024",
            "telephone_number": "541-342-2134",
            "fax_number": "541-684-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD161287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666109",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Kay Suiter
• Sirisha R Sukrutham
• Olugbenga Omotayo Sulaiman, M.D.
• Nancy Sue Sulliger, PMHNP
• Amalia Sullivan, LCSW
• Kathy J. Sullivan, L.C.S.W.
• Kaylee Sullivan, RBAI
• Kelley Sullivan
• Mariah Wynne Beck Sullivan
• Nina Noella Sullivan, LMT

• Family Medicine Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.