Individual provider Active NPI

Paul Jeffrey Sullivan, MD

  • Diagnostic Radiology Physician
  • Dallas, TX
National Provider Identifier
1952366676
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
K9184 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 645-0624
Fax
(214) 645-0078
NPI assigned
Apr 18, 2006
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X K9184 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other identifiers 1

IdentifierTypeStateIssuer
104548605MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040419000511 TX Practitioner - Diagnostic Radiology 9234124272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Howard University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12500 Dallas Pkwy
Frisco, TX 75033-4231
Phone (844) 424-4537

1801 Inwood Rd
Dallas, TX 75235-7202

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-2700

2350 N Stemmons Frwy
Dallas, TX 75207-2700
Phone (844) 424-4537

2350 N Stemmons Fwy
Dallas, TX 75207-2700

2350N Stemmons Fwy 4300
Dallas, TX 75207-2700
Phone (214) 645-0624

2999 Olympus Blvd
Coppell, TX 75019-1205

3000N Interstate 35
Denton, TX 76201-5119
Phone (469) 303-3591

3030 Waterview Pkwy
Richardson, TX 75080-1400

3450 W Camp Wisdom Rd
Dallas, TX 75237-2504
Phone (214) 214-5830

3450 W Camp Wisdom Rd
Dallas, TX 75237-2515
Phone (817) 987-3955

400 W Magnolia Ave
Fort Worth, TX 76104-7617
Phone (817) 288-9800

5151 Harry Hines Blvd
Dallas, TX 75235-7707
Phone (214) 645-2353

5161 Harry Hines Blvd
Dallas, TX 75235-7707

5303 Harry Hines Blvd
Dallas, TX 75390-7208

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-8200

5323 Harry Hines Blvd
Dallas, TX 75390-9257

5939 Harry Hines Blvd
Dallas, TX 75390-0001
Phone (214) 645-0624

5959 Harry Hines Blvd
Dallas, TX 75235-6234

600 S Main St
Fort Worth, TX 76104-2410

6121 N Hwy 161
Irving, TX 75038-2265
Phone (469) 647-4040

6121 N Hwy 161
Irving, TX 75038-2270

6121 N State Highway161
Ste200
Irving, TX 75038-2270
Phone (214) 645-8300

6121 N State Hwy 161
Irving, TX 75038-2265
Phone (469) 647-4700

6121 N State Hwy 161
Suite 300
Irving, TX 75038-2270
Phone (469) 647-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K9184TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2003 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Diagnostic Radiology CurrentSince Nov 1, 2003 Accepting new patients
Lebanon Imaging Associates, PC Diagnostic Radiology Past Accepting new patients

Locations

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1952366676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PAUL",
        "middle_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K9184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104548605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.