DR. MAURA D. SULLIVAN PSY.D.
NPI 1639110273
Psychologist - Clinical in Portland, OR

Q: What is Maura Sullivan's NPI number?

The NPI number for Maura Sullivan is 1639110273. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Q: What is Maura Sullivan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Maura Sullivan was last updated on January 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 08, 2006PECOS EnrolledAccepts Medicare Assignment

3583 NE BROADWAY ST, PORTLAND, OR 97232(503) 432-8470(503) 912-7018 Get Directions Write a Review

NPPES record last updated: January 23, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 29, 2020, Aug 27, 2018 (2 updates tracked since 2018).

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About Dr. Maura D. Sullivan Psy.d. NPPES

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

DR. MAURA D. SULLIVAN PSY.D. (NPI 1639110273) is an individual clinical provider in Portland, Oregon, licensed in New Hampshire (1012) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1639110273

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MAURA D. SULLIVANCredential: PSY.D.

Location Address3583 NE BROADWAY STPortland, OR 97232-1820

Mailing Address3583 Ne Broadway StPortland, OR 97232-1820 · (503) 432-8470 · Fax (503) 912-7018

Phone(503) 432-8470

Fax(503) 912-7018

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateJune 8, 2006

Last NPPES UpdateJanuary 23, 20242 updates tracked since enumeration

NPPES CertifiedJanuary 23, 2024

✔ NPI 1639110273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NH · 1012

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3583 NE BROADWAY ST, Portland, OR 97232

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Other Identifiers 1

Medicaid30425095NH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BridgeSpan Health Company and more.Insurance ›

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. Maura D. Sullivan Psy.d. 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 ID9133102460

PECOS Enrollment IDI20180910001726

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97232 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

$176.88 typical visit price

range $58.99 – $176.88

Typical copayment $44.22 (range $14.74 – $44.22)

Most-billed visit code 99205

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

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 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAUL T GIGER MD

Psychiatry & Neurology (Psychiatry)