DR. STANFORD NORMAN SULLUM MD
NPI 1477660165
Obstetrics & Gynecology in New York, NY
About Dr. Stanford Norman Sullum Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STANFORD NORMAN SULLUM MD (NPI 1477660165) is an individual obstetrics & gynecology provider in New York, New York, licensed in New York (120964) and active in the NPI registry since August 2006. He has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Stanford Norman Sullum Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2015 through July 1, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10128
NEW YORK, NY 10128
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 Stanford Sullum's NPI number?
The NPI number for Stanford Sullum is 1477660165. It was assigned to this individual provider in the NPPES registry on August 25, 2006.
Where is Stanford Sullum located?
Stanford Sullum practices at 1136 5th Ave 1B, New York, NY 10128. The listed phone number is (212) 876-4630.
What is Stanford Sullum's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Stanford Sullum enrolled in Medicare?
No. Stanford Sullum has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Stanford Sullum was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dr. Stanford Norman Sullum, MD · NPI 1477660165
Obstetrics & Gynecology physician in New York, New York. Individual provider, active in the CMS NPPES registry since August 25, 2006.
## Identity
- **NPI:** 1477660165 (Entity type: Individual)
- **Enumerated:** August 25, 2006
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** 120964 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1136 5TH AVE, 1B, New York, NY 10128
- **Phone:** (212) 876-4630 · **Fax:** (212) 876-3478
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 1, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare UPIN B12728; Medicare ID-Type Unspecified 310531
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Source: [NPI Profile](https://npiprofile.com/npi/1477660165) · Data from the CMS NPPES public registry.