Individual provider Active NPI

Jared Daniel Sullivan, CRNA

  • Certified Registered Nurse Anesthetist
  • Pittsburgh, PA
National Provider Identifier
1710309208
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100837 Issued in PA
Practice address
1400 Locust St
Pittsburgh, PA 15219-5114
Phone
(412) 232-8111
NPI assigned
Jan 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN617149 PA
Certified Registered Nurse Anesthetist 367500000X 100837 PA Primary

Addresses

Primary practice location

1400 Locust St
Pittsburgh, PA 15219-5114

Mailing address

1400 Locust St
Pittsburgh, PA 15219-5114
Phone (412) 232-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140315000250 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658502695 Reassigns benefits to 1 organization
I20220103001398 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658502695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

9330 State Rd
Suite 54
Trinity, FL 34655-1808
Phone (727) 834-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN617149PAMDRegistered Nurse
100837PAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Dec 23, 2013 Accepting new patients
University of Pittsburgh Physicians CurrentSince Dec 23, 2013 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Sep 22, 2021 Accepting new patients

Locations

700 Medical Blvd
Englewood, FL 34223
Phone (941) 473-5001

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

1400 Locust St
Pittsburgh, PA 15219
Phone (412) 232-7911

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

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": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1710309208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 LOCUST ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152195114",
            "telephone_number": "412-232-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 LOCUST ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152195114",
            "telephone_number": "412-232-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JARED",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN617149",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "100837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.