Tracy Sullivan, N.P.

Primary specialty

Perinatal Nurse PractitionerTaxonomy code 363LP1700X

License

F390010 Issued in NY

Practice address

3001 Expressway Drive North
Suite #116
Islandia, NY 11749

Phone

(631) 292-6747

Fax

(631) 292-6767

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Lij OB GYN PCGroup PAC ID 7214172980, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: tracysullivan@nslijmedgr.allscriptsdirect.net

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.

• North Shore Lij OB GYN PC

  • Obstetrics Physician
  • Islandia, NY
  • NPI 1033453329
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Contemporary OB GYN Physician Specialists PC

  • Specialist
  • Islandia, NY
  • NPI 1184808990
  NPD (past)

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

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1902989957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXPRESSWAY DRIVE NORTH",
            "address_2": "SUITE #116",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "11749",
            "telephone_number": "631-292-6747",
            "fax_number": "631-292-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EXPRESSWAY DRIVE NORTH",
            "address_2": "SUITE #116",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "11749",
            "telephone_number": "631-292-6747",
            "fax_number": "631-292-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP1700X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Perinatal",
            "state": "NY",
            "license": "F390010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Stergiopoulos, M.D.
• Anna Stern, MD
• Jordan Sudberg, M.D
• Suffolk Medical Services PLLC
• Lorraine Sullivan, NP
• Donna Swan, LPN
• Ruth Tapia
• The Optical Source
• The Therapy Spot for Pediatric & Adult Speech Physical Occupational TH
• Theracare

• Nurse Practitioner in Islandia, NY
• Providers in Islandia, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.