Individual provider Active NPI

Brian Patrick Sullivan, M.D.

  • Otolaryngology Physician
  • Mobile, AL
National Provider Identifier
1932499076
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
32175 Issued in AL
Practice address
2880 Dauphin St
Mobile, AL 36606-2457
Phone
(251) 473-1900
Fax
(251) 470-8943
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 32175 AL Primary

Addresses

Primary practice location

2880 Dauphin St
Mobile, AL 36606-2457

Mailing address

2880 Dauphin St
Mobile, AL 36606-2457
Phone (251) 473-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20160622001643 AL Practitioner - Otolaryngology 6305082363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Alabama School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Management IncGroup PAC ID 6608869342, 55 clinicians

Practice addresses (Care Compare)

126 Alabama Ave W
Thomasville, AL 36784-3100
Phone (334) 636-2529

261 Clubhouse Dr
Gulf Shores, AL 36542-3415
Phone (251) 968-2020

2880 Dauphin St
Mobile, AL 36606-2457
Phone (251) 473-1900

3701 Dauphin St
Mobile, AL 36608-1756
Phone (251) 473-1900

610 Providence Park Dr E
Mobile, AL 36695-4618
Phone (251) 635-0919

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
81.75
Promoting interoperability
77
Improvement activities
40
Cost
75.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32175ALMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Management, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Premier Health Management, Inc. Otolaryngology CurrentSince Jul 1, 2016 Accepting new patients

Locations

2880 Dauphin St
Mobile, AL 36606
Phone (251) 341-3368

610 Providence Park Dr E
Ste 203
Mobile, AL 36695
Phone (251) 633-2667

126 Alabama Ave W
Thomasville, AL 36784
Phone (251) 473-1900

Interoperability endpoints

  • Direct secure messaging: bsullivan@pm.gwaydirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1932499076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062457",
            "telephone_number": "251-473-1900",
            "fax_number": "251-470-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062457",
            "telephone_number": "251-473-1900",
            "fax_number": "251-470-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "32175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.