MARY A SULLIVAN PCNS
NPI 1386662484
Nurse Practitioner - Gerontology in Providence, RI
About Mary A Sullivan Pcns NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY A SULLIVAN PCNS (NPI 1386662484) is an individual gerontology provider in Providence, Rhode Island, licensed in California (21544) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mary A Sullivan Pcns 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.
Medicare Billing Reassignment
Medicare enrollment records show Mary Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Indio, CA 92201
- Reassigned Medicare billing, California enrollment
- 247 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02908 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PROVIDENCE, RI 02908
PROVIDENCE, RI 02908
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 Mary Sullivan's NPI number?
The NPI number for Mary Sullivan is 1386662484. It was assigned to this individual provider in the NPPES registry on July 17, 2006.
Where is Mary Sullivan located?
Mary Sullivan practices at 50 Maude St, Providence, RI 02908. The listed phone number is (401) 456-2000.
What is Mary Sullivan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Mary Sullivan enrolled in Medicare?
Yes. Mary 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.
Which organization bills Medicare for Mary Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Sullivan reassigns Medicare benefits to Telecare Corporation (Indio, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Sullivan was last updated on February 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Mary A Sullivan, PCNS · NPI 1386662484
Gerontology physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since July 17, 2006.
## Identity
- **NPI:** 1386662484 (Entity type: Individual)
- **Enumerated:** July 17, 2006
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 21544 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 50 MAUDE ST, Providence, RI 02908-4325
- **Phone:** (401) 456-2000 · **Fax:** (401) 456-6554
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Telecare Corporation (NPI 1346020658, Indio, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** February 2, 2012
- **Other identifiers:** Medicare UPIN Q64039 (RI)
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Source: [NPI Profile](https://npiprofile.com/npi/1386662484) · Data from the CMS NPPES public registry.