Provider Type Icon

DR. MATTHEW PATRICK SULLIVAN MD NPI 1750609004


NPI Information

NPI: 1750609004
Provider Name: DR. MATTHEW PATRICK SULLIVAN, MD
Classification: Orthopaedic Surgery - 207XX0801X
Entity Type: Individual

Specialization: Orthopaedic Trauma

Organization: UPSTATE ORTHOPEDICS, LLP

PECOS Registration: Yes

Address:
6620 FLY RD
STE 200
EAST SYRACUSE, NY
ZIP 13057
Phone: (315) 464-4472
Get Directions

DR. Matthew Patrick Sullivan, MD is an orthopaedic trauma orthopaedic surgery in East Syracuse, NY with 14 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. DR. Matthew Patrick Sullivan, MD NPI is 1750609004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2010

The provider's business location address is:

6620 FLY RD
STE 200
EAST SYRACUSE, NY
ZIP 13057-791
Phone: (315) 464-4472

The NPI 1750609004 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/12/2010 and was last updated on 11/2/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryMD60545599WASHINGTONNo
2207XX0801XOrthopaedic SurgeryOrthopaedic TraumaMD60545599WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104488400MEDICAIDNEW YORK
2J400320491MEDICARE PINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.