Michael Patrick Sullivan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00033030 Issued in WA

Practice address

1117 Spring St
Friday Harbor, WA 98250-9782

Phone

(360) 378-2141

Fax

(360) 378-3655

NPI assigned

Jul 3, 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 4

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msullivan14854@direct.peacehealth.org

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1447484274
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553
  NPD (past)
• Emergency Physicians of Pittsburgh, LTD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Clairton, PA
  • NPI 1245289131
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1922037548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-378-2141",
            "fax_number": "360-378-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SPRING ST",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982509782",
            "telephone_number": "360-378-2141",
            "fax_number": "360-378-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00033030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "7524SU",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8182263",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0168205",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0302692",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Michele Smith
• Tina Smith, LMP
• Lila Marie Speed, MA
• Barbara Leone Starr, LICSW
• Roberta Michelle Stringer, PT, DPT
• Susan a. Kiraly, DDS, PS
• Trillium S Swanson
• David A Tegrotenhuis, DDS
• The Clearing, SPC
• Julia Ann Thompson, MS PT

• Emergency Medicine Physician in Friday Harbor, WA
• Providers in Friday Harbor, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.