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

Matthew Sullivan, PA

Individual provider Physician Assistant · NPI 1952079915

Matthew Sullivan, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2021, 5 years ago. Practices with Ibrahim Heart Clinic PLLC, a 42-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

9765 San Jose Blvd Ste 102
Jacksonville, FL 32257-5467
Phone: (904) 260-5757
Fax: (904) 268-0733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1952079915
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 2, 2021
Last updated in NPPESDecember 10, 2021
Certification dateDecember 10, 2021
Mailing address3748 Bowden Rd S, Jacksonville, FL 32216-6223

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ibrahim Heart Clinic Pllc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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