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

Richard Henry Sullivan III, PA

Individual provider Physician Assistant · NPI 1407272529

Richard Henry Sullivan III, PA is a Physician Assistant in Alpharetta, Georgia. Qualified in 2014, 12 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment.

Years since qualifying
12
In the registry since
2014
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

3400 Old Milton Pkwy Ste 190
Alpharetta, GA 30005-3707
Phone: (770) 663-1100
Fax: (770) 663-1101
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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 number1407272529
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 13, 2014
Last updated in NPPESMarch 14, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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