Active NPI
Danielle Paige Sullivan
- Family Nurse Practitioner
- Old Saybrook, CT
National Provider Identifier
1932048733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17079
- Practice address
- 1654 Boston Post Rd
Old Saybrook, CT 06475-1600 - Phone
- (860) 391-6449
- Fax
- (860) 391-6450
- NPI assigned
- Mar 26, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F03260571 | CT | |
| Family Nurse Practitioner | 363LF0000X | 17079 | CT | Primary |
Addresses
Primary practice location
1654 Boston Post Rd
Old Saybrook, CT 06475-1600
Mailing address
1290 Silas Deane Hwy
HHC Cvo
Wethersfield, CT 06109-4337
Phone (860) 972-5507
Other practice location 1
1687 Boston Post Rd
Old Saybrook, CT 06475-1608
Phone (860) 391-6449
Other practice location 2
90 Beech St
North Branford, CT 06471-1439
Phone (860) 560-6873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1290 Silas Deane Hwy
Wethersfield, CT 06109
90 Beech St
North Branford, CT 06471-1439
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F03260571 | CT | MD | Nurse Practitioner |
| 17079 | CT | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Avon, CT
- NPI 1093239683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1932048733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SILAS DEANE HWY",
"address_2": "HHC CVO",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094337",
"telephone_number": "860-972-5507",
"fax_number": "860-972-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1654 BOSTON POST RD",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064751600",
"telephone_number": "860-391-6449",
"fax_number": "860-391-6450"
}
],
"practiceLocations": [
{
"address_1": "1687 Boston Post Rd",
"address_purpose": "LOCATION",
"city": "Old Saybrook",
"state": "CT",
"postal_code": "064751608",
"country_code": "US",
"telephone_number": "860-391-6449",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 Beech St",
"address_purpose": "LOCATION",
"city": "North Branford",
"state": "CT",
"postal_code": "064711439",
"country_code": "US",
"telephone_number": "860-560-6873",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "DANIELLE",
"middle_name": "PAIGE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-26",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "F03260571",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "17079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Old Saybrook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.