Drew Sullivan, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G32274 Issued in CA

Practice address

625 Lincoln Ave
San Jose, CA 95126-3705

Phone

(408) 278-3310

Fax

(408) 278-3378

NPI assigned

Aug 11, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Valley Radiologist Medical Associates

  • Magnetic Resonance Imaging Radiologic Technologist
  • San Mateo, CA
  • NPI 1629292297

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1992716997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RACE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263518",
            "telephone_number": "408-278-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263705",
            "telephone_number": "408-278-3310",
            "fax_number": "408-278-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G32274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G322740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrismargareth Lim Sulayao
• Nabeela Suliman
• Megan Lee Sullivan-Boileau, PHD
• Bailey Sullivan
• Bryonna Sullivan
• Jani K Sullivan, MS
• John Sullivan, M.D.
• Leslie A Sullivan, M.D.
• Lisa Sullivan, M.A. LMFT
• Madelyn Sullivan

• Diagnostic Radiology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.