DR. BRENDAN JAMES SULLIVAN (DPT) – Physical Therapist, NPI 1295417624

DR. BRENDAN JAMES SULLIVAN (DPT) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for DR. BRENDAN JAMES SULLIVAN (DPT) is 1295417624

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRENDAN JAMES SULLIVAN (DPT)
NPI
1295417624
Phone
(616) 554-0918
Address
3826 44TH ST SE
Enumeration Date
4 August 2023
Last Update Date
4 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6165540918
Graduation Year
2019 (7 years ago)
PAC ID
2668835042
Group Practice PAC ID
4981679743
Professional Enrollment ID
I20230907001961
Address ID
MI495123919KE3826XSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for DR. BRENDAN JAMES SULLIVAN (DPT)

  • 3826 44TH ST SE

    GRAND RAPIDS, MI 495123919

    Phone: (616) 554-0918

    Fax: (616) 554-3079

    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: 2023-09-07

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
I20230907001961IPhysical Therapist In Private PracticeMITBD

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 49512)

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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: 4981679743View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
-MI

Reviews

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Frequently asked questions

What number should I use to identify DR. BRENDAN JAMES SULLIVAN (DPT) for billing?
Administrative and clinical systems typically use NPI 1295417624 for DR. BRENDAN JAMES SULLIVAN (DPT).
Is DR. BRENDAN JAMES SULLIVAN (DPT)'s NPI status active today?
Active status means DR. BRENDAN JAMES SULLIVAN (DPT)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. BRENDAN JAMES SULLIVAN (DPT)?
NPPES ties DR. BRENDAN JAMES SULLIVAN (DPT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. BRENDAN JAMES SULLIVAN (DPT)?
DR. BRENDAN JAMES SULLIVAN (DPT) shows a connection to Grand Rapids, Michigan in registry-derived data.
Why is information missing for DR. BRENDAN JAMES SULLIVAN (DPT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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