RYAN O'SULLIVAN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104679398

RYAN O'SULLIVAN (CRNA) is a healthcare provider. based in Meadville, Pennsylvania. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. RN709409 (PA). The NPI Number for RYAN O'SULLIVAN (CRNA) is 1104679398

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
RYAN O'SULLIVAN (CRNA)
NPI
1104679398
Phone
(814) 333-5728
Address
1034 GROVE ST
Enumeration Date
8 April 2024
Last Update Date
23 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8143335728
Graduation Year
2025 (1 year ago)
PAC ID
6103306147
Group Practice PAC ID
1557328903
Professional Enrollment ID
I20260218000164
Address ID
PA163352945ME1034XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

4,245 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in PA

Provider Addresses for RYAN O'SULLIVAN (CRNA)

  • 1034 GROVE ST

    MEADVILLE, PA 163352945

    Phone: (814) 333-5728

    Fax: (814) 333-5726

    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: 2026-02-18

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
I20260218000164ICertified Registered Nurse Anesthetist (Crna)PATBD

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 16335)

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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: 1557328903View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)VA
Certified Registered Nurse Anesthetist (Crna)PA
Anesthesiology, Pain ManagementPA
Certified Registered Nurse Anesthetist (Crna)PA
Anesthesiology, Pain ManagementPA
-PA
Certified Registered Nurse Anesthetist (Crna)PA
Anesthesiology, Pain ManagementPA
Certified Registered Nurse Anesthetist (Crna)PA

Reviews

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Frequently asked questions

What unique ID ties claims to RYAN O'SULLIVAN (CRNA)?
NPI 1104679398 is assigned to RYAN O'SULLIVAN (CRNA) under the national enumeration system.
Does this profile mean RYAN O'SULLIVAN (CRNA) is currently active?
Yes — RYAN O'SULLIVAN (CRNA) appears active in the national provider directory.
Does RYAN O'SULLIVAN (CRNA) list a primary specialty?
If you are matching referrals, note Certified Registered Nurse Anesthetist for RYAN O'SULLIVAN (CRNA). Clinical services aligned with this taxonomy classification.
What location metadata exists for RYAN O'SULLIVAN (CRNA)?
The page summarizes Meadville, Pennsylvania for RYAN O'SULLIVAN (CRNA); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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