MRS. MARIN M SULLIVAN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1114043379

MRS. MARIN M SULLIVAN (CRNA) is a healthcare provider. based in Woodland hills, California. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. NA3126 (CA). The NPI Number for MRS. MARIN M SULLIVAN (CRNA) is 1114043379

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARIN M SULLIVAN (CRNA)
NPI
1114043379
Phone
(818) 719-2000
Address
5601 DE SOTO AVE
Enumeration Date
21 March 2007
Last Update Date
13 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8187192000
Graduation Year
2003 (23 years ago)
PAC ID
3971547944
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20111121000221

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

Provider Addresses for MRS. MARIN M SULLIVAN (CRNA)

  • 5601 DE SOTO AVE

    WOODLAND HILLS, CA 913676701

    Phone: (818) 719-2000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111121000221ICertified Registered Nurse Anesthetist (Crna)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91367)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

What is the standard ID for MRS. MARIN M SULLIVAN (CRNA) in the U.S.?
In the U.S., MRS. MARIN M SULLIVAN (CRNA) is identified by NPI 1114043379.
Is MRS. MARIN M SULLIVAN (CRNA)'s NPI status active today?
Active status means MRS. MARIN M SULLIVAN (CRNA)'s NPI record is not deactivated in the public file.
Which specialty label fits MRS. MARIN M SULLIVAN (CRNA)?
NPPES ties MRS. MARIN M SULLIVAN (CRNA) to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to MRS. MARIN M SULLIVAN (CRNA)?
MRS. MARIN M SULLIVAN (CRNA) shows a connection to Woodland Hills, California in registry-derived data.
Why is information missing for MRS. MARIN M SULLIVAN (CRNA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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