JOHN MICHAEL SULLIVAN (NPI# 1689204356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689204356 |
| Entity Type | Individual |
| Full Name | JOHN MICHAEL SULLIVAN |
| Credential | PA-C |
| Practice Address |
60 Fenwood Rd Boston MA 02115-6128 |
| Practice Telephone | 6175256550 |
| Mailing Telephone | 6175256550 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639789027 | John Sullivan | Counselor | 1104 Cavalier Dr, Waukesha, WI 53186-6883 | 2020-07-31 |
| 1659820454 | John Christopher Sullivan | Counselor | 413 N Bridge St, Dewitt, MI 48820-8907 | 2016-09-22 |
| 1538576764 | John Michael Sullivan | Psychologist | One Old Oyster Point Road, Newport News, VA 23602 | 2014-07-21 |
| 1962827808 | John Sullivan | Emergency Medicine | 92 Wood Cove Dr, Coventry, RI 02816-6614 | 2014-03-02 |
| 1225368145 | John Patrick Sullivan Jr. | Psychologist | 8 Bradford Ave, Newport, RI 02840-2202 | 2009-12-29 |
| 1679703425 | John Michael Sullivan | Dentist | 9770 Old Baymeadows Rd Ste 113, Jacksonville, FL 32256-7986 | 2009-07-14 |
| 1649484726 | John F Sullivan | Pharmacist | 44 Timber Ln, Methuen, MA 01844-4644 | 2007-05-09 |
| 1881812410 | John Michael Sullivan | Social Worker | 735 Requa St, Peekskill, NY 10566-4615 | 2007-04-20 |
| 1114049228 | John M Sullivan | Chiropractor | 3945 Us Highway 77, Corpus Christi, TX 78410-4531 | 2007-04-06 |
| 1457412306 | John J Sullivan | Dentist | 325 W White Mountain Blvd, Lakeside, AZ 85929-6875 | 2006-12-13 |
| Street Address |
60 FENWOOD RD |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-6128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881619088 | Laura Morrissey | Social Worker | 60 Fenwood Rd, Boston, MA 02115-6128 | 2006-07-12 |
| 1841856044 | Alexandra Leaverton | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2019-05-13 |
| 1053872895 | Emma Eleanor Taylor Pennock | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115 | 2019-03-26 |
| 1538624135 | Nathaniel Bernardo | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2019-02-07 |
| 1205307600 | Margaret E Naclerio | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-12-10 |
| 1144700535 | Nadim Jiwa | Psychiatry & Neurology | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-08-15 |
| 1972009033 | Sanjali Kumar | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-04-05 |
| 1699270710 | Nishant Kumar Gupta | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-03-29 |
| 1992200125 | Natalie Feldman | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-03-28 |
| 1033613005 | Erica Fay Siwila-sackman | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205435393 | Allison Lee Nocon | Physician Assistant | 289 Beacon St Apt 8, Boston, MA 02116-1263 | 2020-10-20 |
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1639781230 | Amanda Mae Saxton | Physician Assistant | 1410 Columbia Rd Apt 8g, Boston, MA 02127-4016 | 2020-08-17 |
| 1336757137 | Sabrina J Jamiel | Physician Assistant | 144 Calumet St Apt 3, Boston, MA 02120-3378 | 2020-07-17 |
| 1811505969 | Matthew George Cronin | Physician Assistant | 105 Landseer St, Boston, MA 02132-3436 | 2020-07-15 |
| 1902420284 | Rebecca Lee | Physician Assistant | 89 Chester St Apt A5, Boston, MA 02134-2219 | 2020-06-03 |
| 1982239430 | Catherine Dam | Physician Assistant | 357 Commercial St Apt 420, Boston, MA 02109-1236 | 2020-03-05 |
| 1033742390 | Melissa Stathas | Physician Assistant | 32 Fruit St Bldg 5th, Boston, MA 02114-2620 | 2020-02-14 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1275184905 | Danielle Dacunha | Physician Assistant | 42 Worcester Sq Apt 10, Boston, MA 02118-2920 | 2019-09-24 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.