Cassidy Bennett Sullivan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A163333 Issued in CA

Practice address

3711 Long Beach Blvd Ste 700
Long Beach, CA 90807-3353

Phone

(562) 424-8422

NPI assigned

Apr 5, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Merit-based Incentive Payment System (MIPS)

Final score

87.17 of 100Reported as group

Quality

81.15

Promoting interoperability

100

Improvement activities

40

Cost

71.64

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: csullivan539624@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Long Beach Memorial Medical

  • Children's Hospital
  • Long Beach, CA
  • NPI 1477596583
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1821483900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 700",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073353",
            "telephone_number": "562-424-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 700",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073353",
            "telephone_number": "562-424-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CASSIDY",
        "middle_name": "BENNETT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A163333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarath Sujatha-Bhaskar
• Sujin Lee
• Jay Sukow
• Nicole Sulier
• Brittany Sullivan
• Devon Sullivan
• Elizabeth Sullivan, PSY.D.
• Morgan Kimura Sullivan, M.S. CCC-SLP
• Peter Sullivan, MD
• Whitney Sullivan

• Obstetrics & Gynecology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.

Verify at the official NPI Registry.