Jordan Scott Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00670500 Issued in NJ

Practice address

325 Princeton Ave
Princeton, NJ 08540-1617

Phone

(609) 924-8131

Fax

(609) 924-8532

NPI assigned

Apr 3, 2017

Sex

Male

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 NJ

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
• Robert Wood Johnson University Hospital at Hamilton Hospital, Hamilton, NJ, CCN 310110
• Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Orthonj LLC

  • Orthopaedic Surgery Physician
  • Somerset, NJ
  • NPI 1720557432
  Medicare reassignment Care Compare group NPD
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754
  Medicare reassignment
• Orthonj LLC

  • Durable Medical Equipment & Medical Supplies
  • Galloway, NJ
  • NPI 1487448312
  NPD

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

• Kessler Institute for Rehabilitation Inc

  • Rehabilitation Hospital
  • West Orange, NJ
  • NPI 1013919620

  Inpatient rehabilitation facility

  Care Compare affiliation
• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation
• Robert Wood Johnson University Hospital at Hamilton

  • General Acute Care Hospital
  • Hamilton, NJ
  • NPI 1629069638
  Care Compare affiliation

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1881126431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084728",
            "country_code": "US",
            "telephone_number": "401-456-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JORDAN",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00968",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00670500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stuttering Institute of Princeton
• Cristin Devika Subramaniam, M.D.
• Jaya Subramoni, MD
• Kristen Marie Sugarman, RD
• Gerald D. Suh, M.D.
• Surgical Specialists at Princeton LLC
• Susan McCoy LLC
• Gabriela Susana, PA-C
• Naomi Sussman, MSW, LCSW
• Evelyn Ruth Sutkowski, LPC

• Physician Assistant in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.