GAVIN RILEY SULLIVAN PA
NPI 1427916667
Student in an Organized Health Care Education/Training Program in Madera, CA

Q: What is Gavin Sullivan's NPI number?

The NPI number for Gavin Sullivan is 1427916667. It was assigned to this individual provider in the NPPES registry on January 15, 2026.

Q: What is Gavin Sullivan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Gavin Sullivan was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 January 15, 2026PECOS Enrolled

344 E 6TH ST, MADERA, CA 93638(559) 664-4000(559) 675-5224 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Gavin Riley Sullivan Pa NPPES

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

GAVIN RILEY SULLIVAN PA (NPI 1427916667) is an individual student in an organized health care education/training program in Madera, California and active in the NPI registry since January 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1427916667

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameGAVIN RILEY SULLIVANCredential: PA

Location Address344 E 6TH STMadera, CA 93638-3631

Mailing Address344 E 6th StMadera, CA 93638-3631 · (559) 664-4000 · Fax (559) 675-5224

Phone(559) 664-4000

Fax(559) 675-5224

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 15, 2026

NPPES CertifiedJanuary 15, 2026

✔ NPI 1427916667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

344 E 6TH ST, Madera, CA 93638

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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 (PECOS)

Gavin Riley Sullivan Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315422219

PECOS Enrollment IDI20260330000522

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.

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.

SOLEDAD REYES FNP-C

Nurse Practitioner (Family)

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 666-4000

DANIELA IVONNE ULLOA

Dentist

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

ALONDRA JUAREZ

Social Worker (Clinical)

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

MADHURI SHUKLA APRN

Nurse Practitioner

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

HARJEET K GILL NP

Nurse Practitioner (Family)

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

CAROLINA GUTIERREZ GARCIA

Family Medicine

344 E 6TH ST
MADERA, CA 93638

Madera County (442) 228-0681

DR. GERARD N MAZO MD

General Practice

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

GUILLERMO SANDOVAL MD

Pediatrics

344 E 6TH ST
MADERA, CA 93638

Madera County (559) 664-4000

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 Gavin Sullivan's NPI number?

The NPI number for Gavin Sullivan is 1427916667. It was assigned to this individual provider in the NPPES registry on January 15, 2026.

Where is Gavin Sullivan located?

Gavin Sullivan practices at 344 E 6th St, Madera, CA 93638. The listed phone number is (559) 664-4000.

What is Gavin Sullivan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Gavin Sullivan enrolled in Medicare?

Yes. Gavin Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gavin Sullivan was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.