Brian Michael Sullivan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

49845 Issued in MT

Practice address

202 S 4TH St W
Baker, MT 59313-9156

Phone

(406) 778-2833

Fax

(406) 778-5355

NPI assigned

May 23, 2008

Last updated

Jan 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Specialty

Family Practice

Education

University of Pittsburgh School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fallon Medical Complex IncGroup PAC ID 0941119499, shared by 4 NPIs, 6 clinicians

Southwesthealthcare ServicesGroup PAC ID 3173512704, shared by 5 NPIs, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fallon Medical Complex Hospital Hospital, Baker, MT, CCN 271301
• Fallon Medical Complex Hospital Nursing home, CCN 27Z301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fallon Medical Complex Inc

  • Critical Access Hospital
  • Baker, MT
  • NPI 1316965346
  Medicare reassignment NPD
• Fallon Medical Complex Inc

  dba dba Community Clinic

  • Critical Access Hospital Clinic/Center
  • Baker, MT
  • NPI 1386700763
  Medicare reassignment NPD
• Fallon Medical Complex Inc

  dba Wibaux Clinic

  • Health Service Clinic/Center
  • Wibaux, MT
  • NPI 1043229776
  NPD
• Fallon Medical Complex Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Baker, MT
  • NPI 1316013022
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Aurora Urgent Care LLC

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1942318308
  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

• Fallon Medical Complex Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Baker, MT
  • NPI 1316013022

  Nursing home

  Care Compare affiliation
• Fallon Medical Complex Inc

  • Critical Access Hospital
  • Baker, MT
  • NPI 1316965346
  Care Compare affiliation

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1972761252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 AMERICAS WAY",
            "address_2": "APT 6347",
            "city": "BOX ELDER",
            "state": "SD",
            "postal_code": "577197600",
            "telephone_number": "949-444-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S 4TH ST W",
            "city": "BAKER",
            "state": "MT",
            "postal_code": "593139156",
            "telephone_number": "406-778-2833",
            "fax_number": "406-778-5355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Americas Way",
            "address_2": "Apt 6347",
            "address_purpose": "LOCATION",
            "city": "Box Elder",
            "state": "SD",
            "postal_code": "577197600",
            "country_code": "US",
            "telephone_number": "949-444-6695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "49845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Elena Hurley, DPT
• Tylyn Loudermilk
• Mikenna Marie O'Donnell, OTR/L
• Todd Overton
• Eric S Sonsalla, PHARMD
• Superior Care Villa
• Victoria J Susa, DPT
• The Recovery Point Rehab, PLLC
• Taylee Rayne Tolzien
• Dominick Peter Trivisonno, MD

• Family Medicine Physician in Baker, MT
• Providers in Baker, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.

Verify at the official NPI Registry.