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JAY F SULLIVAN MD PC
NPI 1427189638
Family Medicine in Pulaski, NY

Active since March 08, 2007CLIA 33D0971090 · Waiver
4882B NORTH JEFFERSON ST, PULASKI, NY 13142(315) 298-2768 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jay F Sullivan Md Pc NPPES

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

JAY F SULLIVAN MD PC (NPI 1427189638) is a healthcare organization registered as a family medicine in Pulaski, New York and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through March 2, 2028 and lists Jay Frederick Sullivan, Md, as its authorized official.

NPPES Registry Identity

NPI1427189638
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJAY F SULLIVAN MD PC
Location Address4882B NORTH JEFFERSON STPulaski, NY 13142
Mailing Address4882b North Jefferson StPulaski, NY 13142
Phone(315) 298-2768
Organization SubpartNo
Authorized OfficialJay Frederick SullivanMd · (315) 298-2768
Enumeration DateMarch 8, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1427189638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 169461
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4882B NORTH JEFFERSON ST, Pulaski, NY 13142
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Other Identifiers 7

Other799222NY · Aetna Hmo
Other169461-1WNY · Workers Compensation
Other5939163NY · Aetna
Other691259NY · Mvp
Medicaid01538238NY
Other138562NY · Cigna
Other00020708301NY · Univera

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0971090

Jay F Sullivan MD PC · Pulaski, NY
Active · expires Mar 2, 2028
CLIA Number33D0971090
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateMarch 2, 2028
Laboratory DirectorJay F. Sullivan
Laboratory Phone(315) 298-2768
Laboratory LocationJay F Sullivan MD PC4882-B North Jefferson Street, Pulaski, NY 13142
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Jay F Sullivan MD PC's NPI number?

The NPI number for Jay F Sullivan MD PC is 1427189638. It was assigned to this organization in the NPPES registry on March 8, 2007.

Where is Jay F Sullivan MD PC located?

Jay F Sullivan MD PC is located at 4882B North Jefferson St, Pulaski, NY 13142. The listed phone number is (315) 298-2768.

What is Jay F Sullivan MD PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jay F Sullivan MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0971090) is associated with this NPI, valid through March 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jay F Sullivan MD PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.