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MARY A SULLIVAN PCNS
NPI 1386662484
Nurse Practitioner - Gerontology in Providence, RI

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
50 MAUDE ST, PROVIDENCE, RI 02908(401) 456-2000(401) 456-6554 Get Directions Write a Review

NPPES record last updated: February 2, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1386662484
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameMARY A SULLIVANCredential: PCNS
Location Address50 MAUDE STProvidence, RI 02908-4325
Mailing Address50 Maude StProvidence, RI 02908-4325 · (401) 456-2000 · Fax (401) 456-6554
Phone(401) 456-2000
Fax(401) 456-6554
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateJuly 17, 2006
Last NPPES UpdateFebruary 2, 2012
✔ NPI 1386662484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in CA · 21544
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License PPNS00073 (RI)
50 MAUDE ST, Providence, RI 02908
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINQ64039RI

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

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.

PECOS PAC ID8729094131
PECOS Enrollment IDI20120320000963
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.

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.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ROGER WILLIAMS RADIATION THERAPY, LLC
Radiology (Radiation Oncology)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2690
DANIEL N VALICENTI MD
Internal Medicine
50 MAUDE ST, 4TH FLOOR
PROVIDENCE, RI 02908
Providence County (401) 456-5300
MOHAMMAD ABDALLAT MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2077
NEW UNIVERSITY MEDICAL GROUP LLC
Internal Medicine
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2525
ROGER WILLIAMS MEDICAL CENTER
Home Health
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2273
ELINA GOMAN BASKIN O.D.
Optometrist
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 351-5664
RABIH EL-BIZRI MD
Internal Medicine (Pulmonary Disease)
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-5714
ELMHURST EXTENDED CARE FACILITIES, INC.
Skilled Nursing Facility
50 MAUDE ST
PROVIDENCE, RI 02908
Providence County (401) 456-2623

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.

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.