Tara Sullivan, PT, PRPC, WCS, IF

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9955 Issued in AZ

Practice address

3104 E Indian School Rd Ste 120
Phoenix, AZ 85016-6873

Phone

(480) 269-7953

Fax

(480) 769-7953

NPI assigned

Apr 11, 2024

Sex

Female

Sole proprietor

No

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 AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mind to Body Healing LLCGroup PAC ID 2769990266, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mind to Body Healing, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1619785359
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1699528299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 E HIGHLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 E INDIAN SCHOOL RD STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166873",
            "telephone_number": "480-269-7953",
            "fax_number": "480-769-7953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5735 E McKellips Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852152875",
            "country_code": "US",
            "telephone_number": "480-269-7953",
            "fax_number": "480-769-7269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "PT, PRPC, WCS, IF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Sullivan, PA-C
• Patricia Sullivan, PT, DPT, NCS
• Patricia Susana Sullivan, MD MPH
• Paulina Montano Sullivan, MS
• Shea Marie Sullivan
• Gail M Sulski, N.P.
• Joshua Adam Sultan, MD
• Omema Kulsoom Sultan, PHARM.D.
• Fahim Sultani, PHARMD
• Masoud Sultani, M.D.

• Physical Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.