Individual provider Active NPI

Leland Sullivan, MD

  • Emergency Medicine Physician
  • Sparks, NV
National Provider Identifier
1841259686
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11471 Issued in NV
Practice address
2375 E Prater Way
Sparks, NV 89434-9641
Phone
(775) 331-7000
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 11471 NV
Emergency Medicine Physician 207P00000X 11471 NV Primary

Addresses

Primary practice location

2375 E Prater Way
Sparks, NV 89434-9641

Mailing address

832 Willow St
Reno, NV 89502-1304

Other identifiers 1

IdentifierTypeStateIssuer
100506845MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20051021000646 NV Practitioner - Emergency Medicine 3173573250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nevada School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown Calvanese Cameron LTDGroup PAC ID 3577468347, 43 clinicians

Practice addresses (Care Compare)

10101 Double R Blvd
Reno, NV 89521-5931
Phone (775) 324-4040

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11471NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown, Calvanese, Cameron LTD Emergency Medicine CurrentSince Jul 1, 2005 Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

832 Willow St
Reno, NV 89502
Phone (775) 324-4040

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 2

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1841259686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 WILLOW ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E PRATER WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349641",
            "telephone_number": "775-331-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LELAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NV",
            "license": "11471",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "11471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506845",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.