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

Shane Sullivan

Individual provider Physical Therapist · NPI 1942371216

Shane Sullivan is a Physical Therapist in Private Practice in Scottsdale, Arizona. Qualified in 2002, 24 years ago. Accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
24
Licensed in
AZ
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

10133 N 92nd St Ste 101
Scottsdale, AZ 85258-4556
Phone: (480) 584-3334
Fax: (480) 272-9369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 6673 (AZ)
Sports Physical Therapist Taxonomy 2251S0007X · Licence 6673 (AZ)

Record details

NPI number1942371216
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 10, 2006
Last updated in NPPESFebruary 18, 2013

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Scottsdale