TIMOTHY J SULLIVAN
NPI 1235989096
Student in an Organized Health Care Education/Training Program in Emerson, NJ

Q: What is Timothy Sullivan's NPI number?

The NPI number for Timothy Sullivan is 1235989096. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Q: What is Timothy Sullivan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Sullivan was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 25, 2024PECOS Enrolled

25 HOLLYWOOD AVE, EMERSON, NJ 07630(201) 245-7109 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Timothy J Sullivan NPPES

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

TIMOTHY J SULLIVAN (NPI 1235989096) is an individual student in an organized health care education/training program in Emerson, New Jersey and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235989096

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTIMOTHY J SULLIVAN

Location Address25 HOLLYWOOD AVEEmerson, NJ 07630-1709

Mailing Address25 Hollywood AveEmerson, NJ 07630-1709 · (201) 245-7109

Phone(201) 245-7109

Sole ProprietorYes

Enumeration DateMarch 25, 2024

NPPES CertifiedMarch 25, 2024

✔ NPI 1235989096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

25 HOLLYWOOD AVE, Emerson, NJ 07630

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy J Sullivan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Timothy Sullivan's NPI number?

The NPI number for Timothy Sullivan is 1235989096. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Where is Timothy Sullivan located?

Timothy Sullivan practices at 25 Hollywood Ave, Emerson, NJ 07630. The listed phone number is (201) 245-7109.

What is Timothy Sullivan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Timothy Sullivan enrolled in Medicare?

Yes. Timothy Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Sullivan was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.