Individual provider Active NPI

Danielle Paige Sullivan

  • Family Nurse Practitioner
  • Old Saybrook, CT
National Provider Identifier
1932048733
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17079 Issued in CT
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

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260605000335 CT Practitioner - Nurse Practitioner 6204307788 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
F03260571CTMDNurse Practitioner
17079CTMDFamily 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.

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

Verify at the official NPI Registry.