Individual provider Active NPI

Kerry O'Sullivan

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1801474630
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME166459 Issued in FL
Practice address
250 W 57TH St FL 15
New York, NY 10107-1307
Phone
(212) 523-4000
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME166459 FL Primary

Addresses

Primary practice location

250 W 57TH St FL 15
New York, NY 10107-1307

Mailing address

250 W 57TH St FL 15
New York, NY 10107-1307
Phone (212) 523-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240411004866 FL Practitioner - Emergency Medicine 5698114569 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Stat IncGroup PAC ID 5698662054, 12 clinicians
South Miami Criticare IncGroup PAC ID 5092629808, 24 clinicians

Practice addresses (Care Compare)

5000 University Dr
Coral Gables, FL 33146-2008
Phone (786) 308-3902

6200 SW 73 St
Miami, FL 33143-4679
Phone (786) 662-4000

Hospital & facility affiliations

  • Doctors Hospital Hospital, Coral Gables, FL, CCN 100296
  • South Miami Hospital Hospital, Miami, FL, CCN 100154
  • West Kendall Baptist Hospital Hospital, Miami, FL, CCN 100314

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Miami Criticare Inc. Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
E R Stat Inc Emergency Medicine CurrentSince Oct 6, 2024 Accepting new patients

Locations

5000 University Dr
Miami, FL 33146
Phone (305) 666-2111

9555 SW 162nd Ave
Miami, FL 33196
Phone (786) 467-2000

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1801474630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 57TH ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101071307",
            "telephone_number": "212-523-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 57TH ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101071307",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "KERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME166459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.