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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. SULLIVAN CLYDE HANBACK MD
NPI 1417538141
Emergency Medicine in Houston, TX

Active since April 15, 2021PECOS EnrolledAccepts Medicare Assignment
6431 FANNIN STREET, SUITE JJL 270-6, HOUSTON, TX 77030(713) 500-7878(713) 500-0758 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sullivan Clyde Hanback Md NPPES

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

DR. SULLIVAN CLYDE HANBACK MD (NPI 1417538141) is an individual emergency medicine provider in Houston, Texas, licensed in Texas (U4523) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Temple University Hospital, and is a graduate of University Of Alabama School Of Medicine (2021).

NPPES Registry Identity

NPI1417538141
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. SULLIVAN CLYDE HANBACKCredential: MD
Location Address6431 FANNIN STREET, SUITE JJL 270-6Houston, TX 77030
Mailing Address6431 Fannin Street, Suite Jjl 270-6Houston, TX 77030 · (713) 500-7878 · Fax (713) 500-0758
Phone(713) 500-7878
Fax(713) 500-0758
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2021
Enumeration DateApril 15, 2021
Last NPPES UpdateJune 9, 2026
NPPES CertifiedJune 9, 2026
✔ NPI 1417538141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in TX · U4523
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
6431 FANNIN STREET, Houston, TX 77030
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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 and accepts Medicare assignment

Dr. Sullivan Clyde Hanback Md 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 ID941647259
PECOS Enrollment IDI20240322000301
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
26 services26 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
24 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Temple University Hospital

Acute Care Hospitals · Philadelphia, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390027
Location3401 North Broad StreetPhiladelphia, PA 19140 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

SANDHYA AVULA MD
Student in an Organized Health Care Education/Training Program
6431 FANNIN STREET, SUITE NUMBER MSB 3
HOUSTON, TX 77030
Harris County (713) 500-6397
MR. TOMOKI KINOSHITA M.D.
Student in an Organized Health Care Education/Training Program
6431 FANNIN STREET, SUITE 1014
HOUSTON, TX 77030
Harris County (713) 500-7722
KEVIN PRAFUL PATEL DO
Emergency Medicine
6431 FANNIN STREET, JJL270
HOUSTON, TX 77030
Harris County (346) 262-8158
CHRISTINA ROLANDELLI MD
Anesthesiology
6431 FANNIN STREET, SUITE MSB 5.196
HOUSTON, TX 77030
Harris County (713) 500-6223
HASAAN SIDDIQUI
Radiology (Diagnostic Radiology)
6431 FANNIN STREET, MSB 2.010A
HOUSTON, TX 77030
Harris County (713) 500-7488
SHARON R PAN MD
Student in an Organized Health Care Education/Training Program
6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030
Harris County (713) 500-6526
OMAR SHAIKH
Student in an Organized Health Care Education/Training Program
6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030
Harris County (214) 648-5617
DR. STEPHANIE CHIDINMA ASSIMONYE MD
Student in an Organized Health Care Education/Training Program
6431 FANNIN STREET, MSB 2.116
HOUSTON, TX 77030
Harris County (713) 500-7614

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 Sullivan Hanback's NPI number?

The NPI number for Sullivan Hanback is 1417538141. It was assigned to this individual provider in the NPPES registry on April 15, 2021.

Where is Sullivan Hanback located?

Sullivan Hanback practices at 6431 Fannin Street Suite Jjl 270-6, Houston, TX 77030. The listed phone number is (713) 500-7878.

What is Sullivan Hanback's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Sullivan Hanback enrolled in Medicare?

Yes. Sullivan Hanback 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.

Is Sullivan Hanback affiliated with any hospitals?

According to CMS data, Sullivan Hanback is affiliated with Temple University Hospital.

When was this NPI record last updated?

The NPPES record for Sullivan Hanback was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days 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.