Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amanda Kelly Sullivan, PA-C

Individual provider Physician Assistant · NPI 1942087911

Amanda Kelly Sullivan, PA-C is a Physician Assistant in Boston, Massachusetts. Qualified in 2023, 3 years ago. Practices with Hartford Hospital, a 1,040-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
3
Licensed in
CT
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

55 Fruit St
Boston, MA 02114-2621
Phone: (617) 724-5110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 80 Seymour St, Hartford, CT 06102-8000 — (860) 972-1466

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 006343 (CT)

Record details

NPI number1942087911
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 12, 2023
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Hartford Hospital — 1040 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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