DR. CORNELIUS A SULLIVAN (MD) – Anesthesiology Physician, NPI 1629074760

DR. CORNELIUS A SULLIVAN (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 58808 (MA). The NPI Number for DR. CORNELIUS A SULLIVAN (MD) is 1629074760

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
DR. CORNELIUS A SULLIVAN (MD)
NPI
1629074760
Phone
(603) 502-6070
Address
461 PARK DR
Enumeration Date
23 June 2005
Last Update Date
17 February 2011

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6173556000
Graduation Year
1983 (43 years ago)
PAC ID
5294782611
Group Practice PAC ID
0446155568
Professional Enrollment ID
I20120806000004
Address ID
MA021155724BO300XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,323 ANESTHESIOLOGY in MA

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Provider Addresses for DR. CORNELIUS A SULLIVAN (MD)

  • 461, Park Drive, Audubon Square, Boston, Suffolk County, Massachusetts, 02215, United States

    #301

    BOSTON, MA 022153825

    Phone: (603) 502-6070

    Type: Mailing

  • Brigham and Women's Hospital, 75, Francis Street, Roxbury, Boston, Suffolk County, Massachusetts, 02115, United States

    DEPARTMENT OF ANESTHESIOLOGY CWN L2

    BOSTON, MA 021156110

    Phone: (617) 732-5500

    Type: Location

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: 2012-08-06

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
I20120806000004IAnesthesiologyMATBD

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 02215)

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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: 0446155568View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YVA
A N E S T H E S I O L O G YMA
Anesthesiology, Pediatric MedicineMA
-MA
-MA
Anesthesiology, Pediatric Medicine, Critical Care (Intensivists)MA
-MA
A N E S T H E S I O L O G YMA
Pain Management, NeurologyMA
Pediatric Medicine, Critical Care (Intensivists), Internal MedicineMA

Reviews

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Frequently asked questions

Does DR. CORNELIUS A SULLIVAN (MD) have a public NPI I can cite?
Public records show DR. CORNELIUS A SULLIVAN (MD) under NPI 1629074760.
Is DR. CORNELIUS A SULLIVAN (MD)'s NPI status active today?
Active status means DR. CORNELIUS A SULLIVAN (MD)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. CORNELIUS A SULLIVAN (MD)?
NPPES ties DR. CORNELIUS A SULLIVAN (MD) to Anesthesiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DR. CORNELIUS A SULLIVAN (MD)?
The directory associates DR. CORNELIUS A SULLIVAN (MD) with Boston, Massachusetts. Check all listed addresses for suites or satellite offices.
Can I export DR. CORNELIUS A SULLIVAN (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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