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

Mrs. Jacqueline Rose Sullivan, PA

Individual provider Physician Assistant · NPI 1740068253

Mrs. Jacqueline Rose Sullivan, PA is a Physician Assistant in Baltimore, Maryland. Qualified in 2024, 2 years ago. Practices with Medical Practices of Antietam, LLC, a 231-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

520 W Fayette St Ste 300
Baltimore, MD 21201-1756
Phone: (724) 422-2261
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1740068253
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 18, 2023
Last updated in NPPESSeptember 18, 2023
Certification dateSeptember 14, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Medical Practices Of Antietam, Llc — 231 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Baltimore