Robert Lee Sullivan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1401 Issued in NC

Practice address

2325 Aberdeen Blvd
Suite a
Gastonia, NC 28054-0614

Phone

(704) 853-3937

Fax

(704) 853-0840

NPI assigned

Aug 1, 2005

Last updated

Mar 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gaston Eye AssociatesGroup PAC ID 7618945437, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.21 of 100Reported as group

Quality

80.98

Improvement activities

40

Cost

79.41

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gaston Eye Associates

  • Ophthalmology Physician
  • Gastonia, NC
  • NPI 1417945775

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gaston Eye Associates

  • Optometrist
  • Dallas, NC
  • NPI 1770565939
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1023018041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 ABERDEEN BLVD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540614",
            "telephone_number": "704-853-3937",
            "fax_number": "704-853-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 ABERDEEN BLVD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540614",
            "telephone_number": "704-853-3937",
            "fax_number": "704-853-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "62842",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "10930",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890904M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF N C",
            "identifier": "0904M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Suddreth, MSN, NP-C, PMHNP-BC
• Mya Sue-Kam-Ling
• Suhas Pai, MD PA
• Raed Suleiman, MD
• Justin Lee Sullivan I
• Sean Michael Sullivan, MS, MA, LMHCA
• Robert Summey III, LPC
• Michael Carr Sumner, LCSW-A
• Sunny Journey Ahead LLC
• Sunpath LLC

• Optometrist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.