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NANAKO SHANNON SULLIVAN PA
NPI 1871277780
Physician Assistant in Brooklyn, NY

Active since June 12, 2023PECOS Enrolled
760 BROADWAY, BROOKLYN, NY 11206(718) 963-8000 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Nanako Shannon Sullivan Pa NPPES

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

NANAKO SHANNON SULLIVAN PA (NPI 1871277780) is an individual physician assistant in Brooklyn, New York, licensed in New York (034283) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871277780
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameNANAKO SHANNON SULLIVANCredential: PA
Location Address760 BROADWAYBrooklyn, NY 11206-5383
Mailing Address760 BroadwayBrooklyn, NY 11206-5383
Phone(718) 963-8000
Sole ProprietorYes
Enumeration DateJune 12, 2023
Last NPPES UpdateAugust 21, 2025
NPPES CertifiedAugust 21, 2025
✔ NPI 1871277780 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 NY · 034283
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.
760 BROADWAY, Brooklyn, NY 11206
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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)

Nanako Shannon 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 11206 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

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.

MIRIAM Y LITVINTCHOUK PA
Physician Assistant (Medical)
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-8000
SHAZA MOHAMMED ELHASSAN
Personal Emergency Response Attendant
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-8430
MS. ABENA BANFUL
Nurse Practitioner (Family)
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-8000
SHUJA AHMED SHAIK M.D.
Student in an Organized Health Care Education/Training Program
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-8779
DR. GERALDINE ORENDAIN M.D.
Psychiatry & Neurology (Psychiatry)
760 BROADWAY, WOODHULL MEDICAL AND MENTAL HEALTH CENTER
BROOKLYN, NY 11206
Kings County (718) 963-5793
MR. GUY KELLY P.A.
Physician Assistant (Medical)
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-5735
MRS. VIRGINIA J PRYCE N.P.
Nurse Practitioner (Family)
760 BROADWAY
BROOKLYN, NY 11206
Kings County (718) 963-5735
DR. ROGER GRANNUM DDS
Dentist (Oral and Maxillofacial Surgery)
760 BROADWAY, ORAL SURGERY ROOM 2C320
BROOKLYN, NY 11206
Kings County (718) 963-8000

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 Nanako Sullivan's NPI number?

The NPI number for Nanako Sullivan is 1871277780. It was assigned to this individual provider in the NPPES registry on June 12, 2023.

Where is Nanako Sullivan located?

Nanako Sullivan practices at 760 Broadway, Brooklyn, NY 11206. The listed phone number is (718) 963-8000.

What is Nanako Sullivan's specialty?

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

Is Nanako Sullivan enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Nanako Sullivan was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.