NPIMap

Organization Active NPI

Sullivan Internal Medicine Group, P.C.

  • Internal Medicine Physician
  • Monticello, NY
National Provider Identifier
1841295474
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
W00071 Issued in NY
Legal business name
SULLIVAN INTERNAL MEDICINE GROUP, P.C.
Practice address
518 Broadway
Monticello, NY 12701-1157
Phone
(845) 794-1600
Fax
(845) 794-0749
NPI assigned
Jun 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sheldon D. Leidner, MD, FACGNPI 1649275280
Title
President
Phone
(845) 794-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X W00071 NY Primary

Addresses

Primary practice location

518 Broadway
Monticello, NY 12701-1157

Mailing address

518 Broadway
Monticello, NY 12701-1157
Phone (845) 794-1600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841295474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 BROADWAY",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011157",
            "telephone_number": "845-794-1600",
            "fax_number": "845-794-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 BROADWAY",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011157",
            "telephone_number": "845-794-1600",
            "fax_number": "845-794-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN INTERNAL MEDICINE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIDNER",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-794-1600",
        "authorized_official_credential": "MD, FACG"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "W00071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.