Keith Edward Sullivan, DPT in San Bruno, CA - Medicare Physical Therapist Provider

Keith Edward Sullivan, DPT is a medicare enrolled "Physical Therapist - Orthopedic" provider in San Bruno, California. His current practice location is 1001 Sneath Ln, San Bruno, California. You can reach out to his office (for appointments etc.) via phone at (650) 871-8645.

Keith Edward Sullivan is licensed to practice in California (license number 37244) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164823738.

Contact Information

	Keith Edward Sullivan, DPT
	1001 Sneath Ln, San Bruno, CA 94066-2308
	(650) 871-8645
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Keith Edward Sullivan
Gender	Male
Speciality	Physical Therapist - Orthopedic
Location	1001 Sneath Ln, San Bruno, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164823738
Provider Enumeration Date: 09/15/2014
Last Update Date: 01/03/2022

Medicare PECOS Information:

PECOS PAC ID: 8022414762
Enrollment ID: I20210907000318

Medical Identifiers

Medical identifiers for Keith Edward Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164823738	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2251X0800X	Physical Therapist - Orthopedic	37244 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keith Edward Sullivan allows following entities to bill medicare on his behalf.

Provider Name	Permanente Medical Group Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith Edward Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Keith Edward Sullivan, DPT 1717 Los Altos Dr, San Mateo, CA 94402-3602 Ph: (650) 200-9600	Keith Edward Sullivan, DPT 1001 Sneath Ln, San Bruno, CA 94066-2308 Ph: (650) 871-8645

Reviews and Comments

Physical Therapist in San Bruno, CA

Dr. April Pasco Fajardo, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 161 Castleton Way, San Bruno, CA 94066 Phone: 650-274-5566
San Mateo County California Children's Services Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1280 Commodore Dr, San Bruno, CA 94066 Phone: 650-312-8929
Rachel Amato, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2600 Fleetwood Dr, San Bruno, CA 94066 Phone: 650-296-4221
Tom Brandt, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 801 Traeger Ave, San Bruno, CA 94066 Phone: 650-742-2388
Mrs. Patricia Maria Casey, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 801 Traeger Ave, Suite 304, San Bruno, CA 94066 Phone: 650-742-7279 Fax: 650-742-7295
Lesa C Perez, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 801 Traeger Ave Ste 304, San Bruno, CA 94066 Phone: 650-742-2000 Fax: 877-738-4262
Mr. Paul C Yu, P.T Physical Therapist Medicare: Medicare Enrolled Practice Location: 801 Traeger Ave, San Bruno, CA 94066 Phone: 650-742-7110

Keith Edward Sullivan, DPT - Medicare Physical Therapist in San Bruno, CA