KERRY M. SULLIVAN MD
NPI 1861566176
Surgery - Pediatric Surgery in Santa Clara, CA
About Kerry M. Sullivan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KERRY M. SULLIVAN MD (NPI 1861566176) is an individual pediatric surgery provider in Santa Clara, California, licensed in California (G74971) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kerry M. Sullivan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
SANTA CLARA, CA 95051
SANTA CLARA, CA 95051
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 Kerry Sullivan's NPI number?
The NPI number for Kerry Sullivan is 1861566176. It was assigned to this individual provider in the NPPES registry on November 20, 2006.
Where is Kerry Sullivan located?
Kerry Sullivan practices at 710 Lawrence Expy, Santa Clara, CA 95051. The listed phone number is (408) 851-1000.
What is Kerry Sullivan's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.
Is Kerry Sullivan enrolled in Medicare?
Yes. Kerry Sullivan is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kerry Sullivan was last updated on December 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kerry M. Sullivan, MD · NPI 1861566176
Pediatric Surgery physician in Santa Clara, California. Individual provider, active in the CMS NPPES registry since November 20, 2006.
## Identity
- **NPI:** 1861566176 (Entity type: Individual)
- **Enumerated:** November 20, 2006
- **Primary specialty:** Surgery - Pediatric Surgery · taxonomy 2086S0120X
- **State license:** G74971 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 710 LAWRENCE EXPY, Santa Clara, CA 95051-5173
- **Phone:** (408) 851-1000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 13, 2021
- **Other identifiers:** Medicaid 00G749710 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1861566176) · Data from the CMS NPPES public registry.