Kathryn Sullivan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

024377 Issued in NY

Practice address

1825 Eastchester Rd
Bronx, NY 10461-2301

Phone

(349) 271-8904

NPI assigned

Nov 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Danbury Hospital Hospital, Danbury, CT, CCN 070033

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  Medicare reassignment Care Compare group
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Multi-Specialty

  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1831733799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 FRANKLIN STREET EXT",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114349",
            "telephone_number": "631-873-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "349-271-8904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Locust Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106148",
            "country_code": "US",
            "telephone_number": "203-739-7029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5908",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "024377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Luise Sullivan, APRN
• Erin Kathleen Sullivan, OTR/L
• Jacqueline Gloria Sullivan, PA
• Josephine Elisabeth Sullivan, DDS
• Judith Ann Sullivan, LPN
• Kevin John Sullivan, PHARM.D.
• Loretta Sullivan, NP
• Margaret Rose Sullivan, PA-C
• Maria Sullivan
• Mary Sullivan

• Medical Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.