NPIMap

Individual provider Active NPI

Robert Sullivan

  • Internal Medicine Physician
  • Altoona, PA
National Provider Identifier
1790971273
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD032190E Issued in PA
Practice address
1414 9TH Ave
Altoona, PA 16602-2415
Phone
(814) 946-1655
NPI assigned
Sep 19, 2007
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD032190E PA
Internal Medicine Physician 207R00000X MD032190E PA Primary

Addresses

Primary practice location

1414 9TH Ave
Altoona, PA 16602-2415

Mailing address

1414 9TH Ave
Altoona, PA 16602-2415

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.d.sullivan@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071212000373 PA Practitioner - Internal Medicine 3375633522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1414 9TH Ave
Altoona, PA 16602-2452
Phone (814) 946-1655

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.88 of 100Reported as group
Quality
62.63
Promoting interoperability
100
Improvement activities
40
Cost
70.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD032190EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona Regional Health Services, Inc Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Upmc Altoona Regional Health Services, Inc Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1414 9th Ave
Altoona, PA 16602
Phone (814) 949-7621

2323 Broad Ave
Altoona, PA 16601
Phone (814) 944-2015

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

Interoperability endpoints

  • Direct secure messaging: robert.d.sullivan@upmcdirect.com

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.

Hospital & facility affiliations 8

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": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1790971273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 9TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 9TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022415",
            "telephone_number": "814-946-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD032190E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD032190E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.d.sullivan@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.