Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1205199601 Individual Practitioner Female Practitioner

Tara Marie Sullivan

Specialist • Whitestone, NY

Professional Overview & Biography Verified Profile Summary

Tara Sullivan is a registered healthcare professional specializing in Specialist in Whitestone, NY. Practice services are available at 14911 12TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

14911 12th Ave

Whitestone, NY 113571725

Telephone 5165762040
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Whitestone, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
46 Specialists

Practicing in Whitestone, NY (23296 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License NY 1718799

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003179789

SPECIALEDUCATIONM

Kylie Vitale

Speech-Language Pathologist

NPI 1013520980
NPI 1023373792

Master of Science in Education

Dana Bubolo , MA

Speech-Language Pathologist

NPI 1023598976

Master of Arts

Amy Cohen , MA

Specialist

NPI 1043350002

Master of Arts

Megan Schmulbach , OTR

Occupational Therapist

NPI 1043525777

Occupational Therapist Registered

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 20, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location June 20, 2012

Registered at 14911 12TH AVE, WHITESTONE, NY 113571725 (Tel: 5165762040)

📍
Updated Business Mailing Address June 20, 2012

Registered at 14911 12TH AVE, WHITESTONE, NY 113571725 (Tel: 5165762040)

👤
Provider Name / Credentials Updated June 20, 2012

Recorded as TARA SULLIVAN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2012

Specialist (License #1718799 in NY)

🟢
Initial NPI Registration & Enumeration June 20, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205199601
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2012
Last Update: June 20, 2012
Sole Proprietor: No

Mailing Address

14911 12th Ave

Whitestone, NY 113571725

Phone: 5165762040

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.