KEITH EDWARD SULLIVAN DPT
NPI 1164823738
Physical Therapist - Orthopedic in San Bruno, CA

Active since September 15, 2014Accepts Medicare Assignment
1001 SNEATH LN, SAN BRUNO, CA 94066(650) 871-8645 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Keith Edward Sullivan Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH EDWARD SULLIVAN DPT (NPI 1164823738) is an individual orthopedic provider in San Bruno, California, licensed in California (37244) and active in the NPI registry since September 2014. He is a graduate of Other (2010).

NPPES Registry Identity

NPI1164823738
Entity TypeIndividualMale
Primary Taxonomy2251X0800X
Provider Legal NameKEITH EDWARD SULLIVANCredential: DPT
Location Address1001 SNEATH LNSan Bruno, CA 94066-2308
Mailing Address1717 Los Altos DrSan Mateo, CA 94402-3602 · (650) 200-9600
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateSeptember 15, 2014
Last NPPES UpdateJanuary 3, 2022
NPI 1164823738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License Licensed in CA · 37244
Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

1001 SNEATH LN, San Bruno, CA 94066

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Keith Edward Sullivan Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022414762
PECOS Enrollment IDI20210907000318

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Technician
1001 SNEATH LN
SAN BRUNO, CA 94066
Internal Medicine (Sports Medicine)
1001 SNEATH LN, SUITE 104
SAN BRUNO, CA 94066
Pediatrics
1001 SNEATH LN, STE 104
SAN BRUNO, CA 94066
Dentist (General Practice)
1001 SNEATH LN, SUITE 108
SAN BRUNO, CA 94066
Clinic/Center (VA)
1001 SNEATH LN, SUITE 300
SAN BRUNO, CA 94066
Counselor (Addiction (Substance Use Disorder))
1001 SNEATH LN
SAN BRUNO, CA 94066
Psychologist (Clinical)
1001 SNEATH LN
SAN BRUNO, CA 94066
Psychiatry & Neurology (Addiction Psychiatry)
1001 SNEATH LN, SUITE 204
SAN BRUNO, CA 94066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Sullivan's NPI number?

The NPI number for Keith Sullivan is 1164823738. It was assigned to this individual provider in the NPPES registry on September 15, 2014.

Where is Keith Sullivan located?

Keith Sullivan practices at 1001 Sneath Ln, San Bruno, CA 94066. The listed phone number is (650) 871-8645.

What is Keith Sullivan's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Keith Sullivan enrolled in Medicare?

Yes. Keith Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Keith Sullivan was last updated on January 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.