Active NPI
Matthew Patrick Sullivan, MD
- Orthopaedic Trauma Physician
- East Syracuse, NY
National Provider Identifier
1750609004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Trauma Physician
- License
- MD60545599
- Practice address
- 6620 Fly Rd
Ste 200
East Syracuse, NY 13057-9791 - Phone
- (315) 464-4472
- NPI assigned
- May 12, 2010
- Last updated
- Nov 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD60545599 | WA | |
| Orthopaedic Trauma Physician | 207XX0801X | MD60545599 | WA | Primary |
Addresses
Primary practice location
6620 Fly Rd
Ste 200
East Syracuse, NY 13057-9791
Mailing address
6620 Fly Rd
Ste 200
East Syracuse, NY 13057-9791
Phone (315) 464-4472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04488400 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Boston University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
208 Township Blvd
Suite 200
Camillus, NY 13031-1674
Phone (315) 551-6000
6620 Fly Rd
Suite 100
East Syracuse, NY 13057-4281
Phone (315) 484-4472
Hospital & facility affiliations
- HCR Home Care
- Centerwell Home Health
- University Hospital S U N Y Health Science Center
- Oneida Health Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.43 of 100
- Quality
- 90.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.73
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Knee replacement | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60545599 | WA | MD | Orthopaedic Trauma Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upstate Orthopedics, LLP | Orthopaedic Surgery | Current | Accepting new patients |
| Upstate Orthopedics, LLP | Orthopaedic Surgery | Current | Accepting new patients |
| Suny Health Science Center at Syracuse | Past | Accepting new patients |
Locations
208 Township Blvd
Ste 200
Camillus, NY 13031
Phone (315) 464-4472
6620 Fly Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 464-4472
6620 Fly Rd
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472
Interoperability endpoints
- msullivan59839@direct.upstate.edu
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- East Syracuse, NY
- NPI 1740228311
-
- Durable Medical Equipment & Medical Supplies
- Camillus, NY
- NPI 1871290445
Orthopaedic Surgery
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1578554630
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Oneida Healthcare Center
- General Acute Care Hospital
- Oneida, NY
- NPI 1962408203
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1578554630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478044800000",
"number": "1750609004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6620 FLY RD",
"address_2": "STE 200",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130579791",
"telephone_number": "315-464-4472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6620 FLY RD",
"address_2": "STE 200",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130579791",
"telephone_number": "315-464-4472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MATTHEW",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-12",
"last_updated": "2016-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD60545599",
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "WA",
"license": "MD60545599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04488400",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.