Nicholas W Sullivan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

74439-21 Issued in WI

Practice address

3209 Dryden Dr
Madison, WI 53704-3015

Phone

(608) 241-9020

Fax

(608) 240-4237

NPI assigned

Apr 2, 2019

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 WI

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

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Community Health Centers IncGroup PAC ID 0345153672, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Access Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Madison, WI
  • NPI 1417055617
  Medicare reassignment Care Compare group NPD
• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• Access Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Madison, WI
  • NPI 1669654307
  NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD

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

• University of Wisconsin Hospitals and Clinics Authority

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1922560713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 DRYDEN DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043015",
            "telephone_number": "608-241-9020",
            "fax_number": "608-240-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICHOLAS",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "74439",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74439-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Sullivan, APNP
• Lawren A Sullivan, MS CCCA
• Megan Sullivan, LMT
• Megan K. Sullivan, NP
• Nate Sullivan, APNP
• Paula Ann Sullivan, MS, CCC-SLP
• Phoebe Manning Sullivan, CNM
• Rachel Sullivan, APNP
• Stacy L Sullivan, LPC
• Joette Kay Suloff, R.PH.

• Family Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.