Patrick G Sullivan, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G74231 Issued in CA

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942

Phone

(619) 460-5111

Fax

(619) 460-7815

NPI assigned

Dec 4, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Orange Coast Anesthesia Inc

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1508138256
  Medicare reassignment NPD
• Premiercare Anesthesia Fountain Valley Inc

  • Anesthesiology Physician
  • Fountain Valley, CA
  • NPI 1831536531
  Medicare reassignment NPD
• San Diego Anesthesia Consulting GRP Inc

  • Specialist
  • La Mesa, CA
  • NPI 1083056733
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1750449955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3617",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919443617",
            "telephone_number": "619-460-5111",
            "fax_number": "619-460-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-460-5111",
            "fax_number": "619-460-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G74231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G742310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Isamu Sugita, D.D.S.
• Eugene Sukhorukov, DDS
• Dawn Denea Sullivan, RRT
• Jack F Sullivan, MA, MFT
• James Sullivan
• Susan Sullivan
• Suman K Sinha MD a Medical Corporation
• Karl Tscha-Ning Sun, MD
• Sunil Jeswani, MD a Professional Corporation
• Carol J Sunofsky, D.C.

• Anesthesiology Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.