Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin Micheal Sullivan, PA-C

Individual provider Physician Assistant · NPI 1821634239

Justin Micheal Sullivan, PA-C is a Physician Assistant in Stratford, New Jersey. Qualified in 2019, 7 years ago. Practices with Kennedy Medical Group Practice, PC, a 414-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
7
Licensed in
NJ
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

205 E Laurel Rd
Stratford, NJ 08084-1301
Phone: (856) 344-2315
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00553600 (NJ)

Record details

NPI number1821634239
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 20, 2019
Last updated in NPPESFebruary 11, 2020
Certification dateFebruary 11, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Kennedy Medical Group Practice, P.C. — 414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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