NPIMap

Individual provider Active NPI

Emma Sullivan

  • Physician Assistant
  • Charlestown, MA
National Provider Identifier
1881223410
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7733 Issued in MA
Practice address
36 1St Ave
Charlestown, MA 02129-4557
Phone
(954) 873-4998
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA7733 MA Primary

Addresses

Primary practice location

36 1St Ave
Charlestown, MA 02129-4557

Mailing address

36 1St Ave
Charlestown, MA 02129-4557
Phone (954) 873-4998

Other practice location 1

41 Mall Rd
Burlington, MA 01805-4557
Phone (781) 744-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217002516 MA Practitioner - Physician Assistant 5597177493 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Regional Physician Group, Inc. CurrentSince Mar 24, 2022 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Mar 24, 2022 Accepting new patients
Lahey Clinic, Inc. CurrentSince May 1, 2022 Accepting new patients
Lahey Clinic, Inc CurrentSince May 1, 2022 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

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

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

Interoperability endpoints

  • Direct secure messaging: esullivan181171@direct.bilh.masshiway.net
  • Direct secure messaging: sullivan.emma.bwh@direct.partners.masshiway.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1881223410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 1ST AVE",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021294557",
            "telephone_number": "954-873-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 1ST AVE",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021294557",
            "telephone_number": "954-873-4998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018054557",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, MA

Sources for this page

Verify at the official NPI Registry.