Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1750689311 Individual Practitioner Female Practitioner

Mallory Sullivan , PA

Physician Assistant • Providence, RI

Professional Overview & Biography Verified Profile Summary

Mallory Sullivan, PA is a registered healthcare professional specializing in Physician Assistant in Providence, RI. Practice services are available at 593 EDDY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

593 Eddy St

Providence, RI 029034923

Telephone 4015191604
Fax 4012720538
Associated Practice Facility / Clinic
🏢 Rhode Island Hospital Facility NPI 1588659528

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.6 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
267 Specialists

Practicing in Providence, RI (687 Statewide)

Telehealth Adoption Rate
16.5% 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

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License RI PA00585

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
MS84572 (RI)
Commercial Insurance / Payer ID Ri Medicare
0021394 (RI)
Commercial Insurance / Payer ID Nhpri
06-09-2011 (RI)
Commercial Insurance / Payer ID United Healthcare
06012011 (RI)
Commercial Insurance / Payer ID Bcbsri
06-18-2011 (RI)
Commercial Insurance / Payer ID Ri Medicare Group
939025129 (RI)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Robert Partridge , MD

Emergency Medicine

NPI 1003836958

Doctor of Medicine (M.D.)

Dr. Otto Liebmann , MD

Emergency Medicine

NPI 1023039146

Doctor of Medicine (M.D.)

Dr. Achyut Kamat , MD

Emergency Medicine

NPI 1043234792

Doctor of Medicine (M.D.)

Dr. Jonathan Valente , MD

Emergency Medicine

NPI 1053327197

Doctor of Medicine (M.D.)

Allison Proano , PA

Physician Assistant

NPI 1063426252

Physician Assistant

Dr. Joseph Lauro , MD

Emergency Medicine

NPI 1063657526

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active August 06, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location August 06, 2013

Registered at 593 EDDY ST, PROVIDENCE, RI 029034923 (Tel: 4015191604)

📍
Updated Business Mailing Address August 06, 2013

Registered at PO BOX 9484, PROVIDENCE, RI 029409484 (Tel: 4018542500)

👤
Provider Name / Credentials Updated August 06, 2013

Recorded as MALLORY SULLIVAN, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 06, 2013

Physician Assistant (License #PA00585 in RI)

🟢
Initial NPI Registration & Enumeration March 07, 2011

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: 1750689311
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 07, 2011
Last Update: August 06, 2013
Sole Proprietor: No

Mailing Address

Po Box 9484

Providence, RI 029409484

Phone: 4018542500

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.