Mary Cecilia Sullivan, MSN, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

001625 Issued in CT

Practice address

1 Elmcroft Rd
Stamford, CT 06926-0700

Phone

(203) 351-7700

NPI assigned

Jun 4, 2009

Sex

Female

Sole proprietor

No

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

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: mary.sullivan.p1@direct.cwpw.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Boston Children'S Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1861628893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELMCROFT RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069260700",
            "telephone_number": "203-351-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELMCROFT RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069260700",
            "telephone_number": "203-351-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY",
        "middle_name": "CECILIA",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "001625",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380181-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Sullivan, OT
• Daria Elizabeth Sullivan, LPC
• Elizabeth Cingari Sullivan, OT
• Grace Sullivan
• Lisa Worden Sullivan, PH.D.
• Michael Robert Sullivan
• Sean Raymond Sullivan, DPT, ATC
• Melissa Grace Sumadchat, BCBA
• Summer Pediatrics LLC
• Summer Street ASC LLC

• Family Nurse Practitioner in Stamford, CT
• Providers in Stamford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.