Individual provider Active NPI

Sullivan McIntosh Smith, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Burlington, MA
National Provider Identifier
1851852560
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
1021889 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-3328
Phone
(781) 744-8000
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 125.074394 IL
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 1021889 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-3328

Mailing address

PO Box 24520
New York, NY 10087-3720
Phone (781) 744-8085

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (781) 635-5061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240711001275 NY Practitioner - Otolaryngology 0941539233 Reassigns benefits to 1 organization
I20250627000357 MA Practitioner - Otolaryngology 0941539233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.074394ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vito C. Quatela, MD PLLC CurrentSince Jul 1, 2024 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

973 East Ave
#100
Rochester, NY 14607
Phone (585) 244-1000

973 East Ave
Rochester, NY 14607
Phone (585) 244-1000

Interoperability endpoints

  • Direct secure messaging: ssmith102061@direct.luhs.org

Organizations & group practices 4

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 4

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1851852560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873720",
            "telephone_number": "781-744-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018053328",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "781-635-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SULLIVAN",
        "middle_name": "MCINTOSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125.074394",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MA",
            "license": "1021889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.