Keith Edward Sullivan, DPT - Medicare Physical Therapist in San Bruno, CA

Keith Edward Sullivan, DPT is a medicare enrolled "Physical Therapist - Orthopedic" provider in San Bruno, California. His current practice location is 1001 Sneath Ln, San Bruno, California. You can reach out to his office (for appointments etc.) via phone at (650) 871-8645.

Keith Edward Sullivan is licensed to practice in California (license number 37244) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164823738.

Contact Information

Keith Edward Sullivan, DPT
1001 Sneath Ln,
San Bruno, CA 94066-2308
(650) 871-8645
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKeith Edward Sullivan
GenderMale
SpecialityPhysical Therapist - Orthopedic
Location1001 Sneath Ln, San Bruno, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1164823738
  • Provider Enumeration Date: 09/15/2014
  • Last Update Date: 01/03/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8022414762
  • Enrollment ID: I20210907000318

Medical Identifiers

Medical identifiers for Keith Edward Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164823738NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2251X0800XPhysical Therapist - Orthopedic 37244 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keith Edward Sullivan allows following entities to bill medicare on his behalf.
Provider NamePermanente Medical Group Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith Edward Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Keith Edward Sullivan, DPT
1717 Los Altos Dr,
San Mateo, CA 94402-3602

Ph: (650) 200-9600
Keith Edward Sullivan, DPT
1001 Sneath Ln,
San Bruno, CA 94066-2308

Ph: (650) 871-8645

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.