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

Q: 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.

Q: What is Sullivan Hanback's specialty?

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

Q: 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 4 months 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 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: October 25, 2026.

On this page

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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Sendero Health Plans, Local Nonprofit.Insurance ›

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

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, I20260508000353

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.

Medicare Billing Reassignments

Medicare enrollment records show Sullivan Hanback reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Travis County Emergency Physicians PA

147 mi

Emergency Medicine

1201 W 38TH ST
Austin, TX 78705

Reassigned Medicare billing, Texas enrollment
1,511 clinicians in this Medicare group

NPI 1962440933 (330) 493-4443

Temple Faculty Practice Plan Inc

1,346 mi

Family Medicine

1700 N BROAD ST
Philadelphia, PA 19121

Reassigned Medicare billing, Pennsylvania enrollment
1,991 clinicians in this Medicare group

NPI 1487136495 (215) 204-2679

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 2

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

Houston Methodist Willowbrook Hospital

Acute Care Hospitals · Houston, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450844

Location18220 State Highway 249Houston, TX 77070 · Harris 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

JANET NWOKOLO-ANIEKWU M.D.

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, SUITE JJL 310
HOUSTON, TX 77030

Harris County (512) 804-9948

LEVANI IASHVILI MD

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 2.262
HOUSTON, TX 77030

Harris County (346) 565-2900

MISS JOCELYN DERIENNE MACK URSUA

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030

Harris County (318) 210-7066

YARA NEAIMEH MD

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 3200
HOUSTON, TX 77030

Harris County (713) 500-7094

REX ALVIN DE GUZMAN PAULINO M.D.

Family Medicine (Hospice and Palliative Medicine)

6431 FANNIN STREET, MSB 5.111
HOUSTON, TX 77030

Harris County (713) 500-6295

DR. SAMIM SYED JAFRI M.D.

Internal Medicine (Pulmonary Disease)

6431 FANNIN STREET, SUITE MSB 1.434
HOUSTON, TX 77030

Harris County (832) 325-7222

CYNTHIA ORANTES MD

Emergency Medicine

6431 FANNIN STREET, SUITE JJL 431
HOUSTON, TX 77030

Harris County (713) 500-7878

JUSTIN SALMAN DO

Internal Medicine

6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030

Harris County (713) 500-6526

EVELYN TRAN MD

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030

Harris County (713) 500-6526

MARCUS A FLOREZ

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 1.134
HOUSTON, TX 77030

Harris County (713) 500-6526

MR. MUHAMMAD JAFAR KHAN

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 1.134, DEPT OF INTERNAL MEDICINE
HOUSTON, TX 77030

Harris County (713) 500-6526

MARINA ATEF AWAD MICHAEL MD

Student in an Organized Health Care Education/Training Program

6431 FANNIN STREET, MSB 2.262
HOUSTON, TX 77030

Harris County (713) 500-5302

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.

Which organizations bill Medicare for Sullivan Hanback's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sullivan Hanback reassigns Medicare benefits to 2 organizations: Travis County Emergency Physicians PA (Austin, TX) and Temple Faculty Practice Plan Inc (Philadelphia, PA). Each 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 Sullivan Hanback's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sullivan Hanback accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Sendero Health Plans, Local Nonprofit list Sullivan Hanback as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sullivan Hanback affiliated with any hospitals?

According to CMS data, Sullivan Hanback is affiliated with Temple University Hospital and Houston Methodist Willowbrook 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 4 months 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.