David Sullo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

222201 Issued in NY

Practice address

220 Linden Oaks
Suite 200
Rochester, NY 14625-2839

Phone

(585) 381-4982

Fax

(585) 381-1821

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dsullo@panoramapeds.medentdirect.com

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.

• Panorama Pediatric Group, RLLP

  • Pediatrics Physician
  • Rochester, NY
  • NPI 1528146453
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1902901648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 LINDEN OAKS",
            "address_2": "SUITE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252839",
            "telephone_number": "585-381-4982",
            "fax_number": "585-381-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LINDEN OAKS",
            "address_2": "SUITE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252839",
            "telephone_number": "585-381-4982",
            "fax_number": "585-381-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLO",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "222201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02180298",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BLUE CHOICEE",
            "identifier": "P010222201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7216284",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MDG382",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ROCHESTER",
            "identifier": "P020222201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "POMCO",
            "identifier": "RC60222201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP UPSTATE DHP",
            "identifier": "782549",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Sullivan, LPN
• Richard Patrick Sullivan, M.D.
• Shannon Sullivan, MSW
• Terri Ryan Sullivan, RDH
• Wendy L Sullivan, M.S. CCC-SLP
• Muhammad Akbar Sulman
• Tahsin Sultana, MD
• Jolene Lynette Summa
• Emma Gail Summers, D.C.
• Amy D. Sumner, LCSW

• Pediatrics Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.