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

Mrs. Nicole Sullivan, PA

Individual provider Physician Assistant · NPI 1649367061

Mrs. Nicole Sullivan, PA is a Physician Assistant in Brooklyn, New York. Qualified in 2004, 22 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
22
Licensed in
NY
In the registry since
2006
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

699 92nd St
Brooklyn, NY 11228-3619
Phone: (212) 563-2497
Fax: (212) 563-0605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 009916 (NY)

Record details

NPI number1649367061
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 6, 2006
Last updated in NPPESDecember 17, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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