PAUL SULLIVAN (PT, DPT) – Physical Therapist, NPI 1245695402

PAUL SULLIVAN (PT, DPT) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in Physical Therapist. They hold the professional credentials PT, DPT. They hold a License No. 40QA01649500 (NJ). The NPI Number for PAUL SULLIVAN (PT, DPT) is 1245695402

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
PAUL SULLIVAN (PT, DPT)
NPI
1245695402
Phone
(800) 321-9999
Address
833 CHESTNUT ST
Enumeration Date
15 December 2015
Last Update Date
1 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8564780275
Graduation Year
2015 (11 years ago)
PAC ID
1951693126
Group Practice PAC ID
7113834102
Professional Enrollment ID
I20160708000038
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for PAUL SULLIVAN (PT, DPT)

  • 833 CHESTNUT ST

    STE 1402

    PHILADELPHIA, PA 191074404

    Phone: (800) 321-9999

    Fax: (267) 339-3761

    Type: Mailing

  • 34 MANCHESTER AVE

    FORKED RIVER, NJ 087311366

    Phone: (609) 693-9345

    Fax: (609) 693-9347

    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: 2016-07-08

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
I20160708000038IPhysical Therapist In Private PracticeNJTBD

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 19107)

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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: 7113834102View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeOH
Orthopedic SurgeryPA
-OH
Physical Therapist In Private PracticeNJ
-PA
Physical Therapist In Private PracticeNJ
-NJ
Physical Therapist In Private PracticeOH

Reviews

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Frequently asked questions

What identifier follows PAUL SULLIVAN (PT, DPT) across health systems?
The NPI 1245695402 uniquely identifies PAUL SULLIVAN (PT, DPT) in U.S. healthcare data.
Is PAUL SULLIVAN (PT, DPT) currently accepting referrals based on NPI status?
Registry metadata lists PAUL SULLIVAN (PT, DPT) as active.
How should patients interpret PAUL SULLIVAN (PT, DPT)'s specialty?
The extract shows Physical Therapist for PAUL SULLIVAN (PT, DPT). Clinical services aligned with this taxonomy classification.
What city is tied to PAUL SULLIVAN (PT, DPT)?
The directory associates PAUL SULLIVAN (PT, DPT) with Philadelphia, Pennsylvania. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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