Individual provider Active NPI

Arthur Francis Sullivan IV, M.D.

  • Emergency Medicine Physician
  • Renton, WA
National Provider Identifier
1972709368
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60131822 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 228-3450
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60131822 WA Primary
Emergency Medicine Physician 207P00000X RS2007-0308 NM

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

PO Box 24584
Seattle, WA 98124
Phone (425) 656-4255

Other identifiers 1

IdentifierTypeStateIssuer
RS2007-0308OtherNMTRAINING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100715000758 WA Practitioner - Emergency Medicine 4183756893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Francisco School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Emergency Room Physicians Inc PSGroup PAC ID 7911892054, 28 clinicians

Practice addresses (Care Compare)

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3440

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.2
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS2007-0308NMMDEmergency Medicine Physician
MD60131822WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Emergency Room Physicians, Inc P.S. Emergency Medicine CurrentSince Jul 1, 2010 Accepting new patients

Locations

25246 Network Pl
Chicago, IL 60673

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

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.

Hospital & facility affiliations 2

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1972709368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98124",
            "telephone_number": "425-656-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ARTHUR",
        "middle_name": "FRANCIS",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60131822",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "RS2007-0308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING",
            "identifier": "RS2007-0308",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.