Individual provider Active NPI

Brian P Sullivan, MD

  • Obstetrics & Gynecology Physician
  • Hanover, MA
National Provider Identifier
1699750265
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
74990 Issued in MA
Practice address
135 Webster St
Hanover, MA 02339-1200
Phone
(781) 878-7020
Fax
(781) 871-3590
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 74990 MA Primary

Addresses

Primary practice location

135 Webster St
Hanover, MA 02339-1200

Mailing address

4 Evergreen St
Hingham, MA 02043-1014

Other identifiers 6

IdentifierTypeStateIssuer
3183238MedicaidMA
1025541OtherAETNA
J12638OtherMABCBS
13867OtherMAHPHC
139146OtherCIGNA
74990OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050420001250 MA Practitioner - Obstetrics/Gynecology 1153369004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Massachusetts Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor Medical Associates IncGroup PAC ID 2466356209, 130 clinicians

Practice addresses (Care Compare)

15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

541 Main St
Suite 314
South Weymouth, MA 02190-1857
Phone (781) 952-1460

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

1681 Washington St
Braintree, MA 02184
Phone (781) 348-9041

135 Webster St
Hanover, MA 02339
Phone (781) 878-7020

6 Shipyard Dr
Ste 2A
Hingham, MA 02043
Phone (781) 556-0200

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Interoperability endpoints

  • Direct secure messaging: sullivan.brian.bwh@direct.partners.masshiway.net

Organizations & group practices 4

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1699750265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVERGREEN ST",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020431014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WEBSTER ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391200",
            "telephone_number": "781-878-7020",
            "fax_number": "781-871-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRIAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "74990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3183238",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1025541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J12638",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "13867",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "139146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "74990",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MA

Sources for this page

Verify at the official NPI Registry.