DR. MICHAEL OSULLIVAN (DO) – Student in an Organized Health Care Education/Training Program, NPI 1043887300

DR. MICHAEL OSULLIVAN (DO) is a healthcare provider. based in Springfield, Massachusetts. specializing in PSYCHIATRY. They hold the professional credentials DO. They hold a License No. 288395 (MA). The NPI Number for DR. MICHAEL OSULLIVAN (DO) is 1043887300

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL OSULLIVAN (DO)
NPI
1043887300
Phone
(413) 794-0000
Address
759 CHESTNUT ST
Enumeration Date
7 June 2021
Last Update Date
7 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Secondary Phone
8608898331
Graduation Year
2021 (5 years ago)
PAC ID
2264835636
Group Practice PAC ID
0749170645
Professional Enrollment ID
I20231206002096
Address ID
CT063602740NO326XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,743 PSYCHIATRY in MA

Provider Addresses for DR. MICHAEL OSULLIVAN (DO)

  • 759 CHESTNUT ST

    SPRINGFIELD, MA 011990001

    Phone: (413) 794-0000

    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: 2023-12-06

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
I20231206002096IPsychiatryCTTBD

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 01199)

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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: 0749170645View full group profile
NameSpecialtyState
Nurse PractitionerCT
Emergency MedicineRI
Hematology/Oncology, Medical OncologyNJ
Physician AssistantME
Hospitalist, Internal MedicineNY
Physician AssistantCT
Physician AssistantGA
Internal MedicineCT
Physician AssistantRI
Physician AssistantMA

Reviews

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Frequently asked questions

What is the registry number for DR. MICHAEL OSULLIVAN (DO)?
The registry entry for DR. MICHAEL OSULLIVAN (DO) shows NPI 1043887300.
Should I treat DR. MICHAEL OSULLIVAN (DO) as an active provider?
Patients and plans typically see DR. MICHAEL OSULLIVAN (DO) as active in the national extract.
How should patients interpret DR. MICHAEL OSULLIVAN (DO)'s specialty?
The extract shows Student in an Organized Health Care Education/Training Program for DR. MICHAEL OSULLIVAN (DO). Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. MICHAEL OSULLIVAN (DO)?
DR. MICHAEL OSULLIVAN (DO) is associated with Springfield, Massachusetts in the same public data insurers reference.
Why is information missing for DR. MICHAEL OSULLIVAN (DO)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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