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MALLORY SULLIVAN PA
NPI 1750689311
Physician Assistant in Providence, RI

Active since March 07, 2011PECOS Enrolled
97.91/100
CMS Quality Rating
593 EDDY ST, PROVIDENCE, RI 02903(401) 519-1604(401) 272-0538 Get Directions Write a Review

NPPES record last updated: August 6, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mallory Sullivan Pa NPPES

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

MALLORY SULLIVAN PA (NPI 1750689311) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA00585) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750689311
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMALLORY SULLIVANCredential: PA
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing AddressPo Box 9484Providence, RI 02940-9484 · (401) 854-2500 · Fax (401) 854-2519
Phone(401) 519-1604
Fax(401) 272-0538
Sole ProprietorNo
Enumeration DateMarch 7, 2011
Last NPPES UpdateAugust 6, 2013
✔ NPI 1750689311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in RI · PA00585
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
593 EDDY ST, Providence, RI 02903
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Other Names 1

Former Name (1)Mallory Schnare

Other Identifiers 6

Other06-09-2011RI · Nhpri
Other939025129RI · Ri Medicare Group
Other0021394RI · Ri Medicare
Other06-18-2011RI · Bcbsri
Other06012011RI · United Healthcare
MedicaidMS84572RI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 02903 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.91/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.97
Promoting Interoperability100
Improvement Activities40

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.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Mallory Sullivan's NPI number?

The NPI number for Mallory Sullivan is 1750689311. It was assigned to this individual provider in the NPPES registry on March 7, 2011. The provider is also known as Mallory Schnare.

Where is Mallory Sullivan located?

Mallory Sullivan practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 519-1604.

What is Mallory Sullivan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mallory Sullivan enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mallory Sullivan was last updated on August 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.