Individual provider Active NPI

John Joseph Sullivan, MD

  • Gynecology Physician
  • Cincinnati, OH
National Provider Identifier
1053340372
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
35.060447 Issued in OH
Practice address
11135 Montgomery Rd
Cincinnati, OH 45249-2308
Phone
(513) 793-2220
Fax
(513) 793-5933
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 35.060447 OH Primary

Addresses

Primary practice location

11135 Montgomery Rd
Cincinnati, OH 45249-2308

Mailing address

4685 Forest Ave
Ste C
Cincinnati, OH 45212-3359
Phone (513) 793-2220

Other identifiers 1

IdentifierTypeStateIssuer
09714269030MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111228000730 OH Practitioner - Obstetrics/Gynecology 2264608074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Cincinnati College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

10550 Montgomery Rd
Suite 22
Montgomery, OH 45242-4422
Phone (513) 793-2229

375 Dixmyth Ave
Cincinnati, OH 45220-2475

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 246-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.060447OHMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients
Trihealth G LLC CurrentSince Jan 1, 2016 Accepting new patients
Trihealth H LLC CurrentSince Nov 1, 2021 Accepting new patients
Bethesda Hospital Inc Past Accepting new patients

Locations

11135 Montgomery Rd
Cincinnati, OH 45249
Phone (513) 793-2220

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

10550 Montgomery Rd
Ste 22
Montgomery, OH 45242
Phone (513) 793-2229

4685 Forest Ave
Ste C
Norwood, OH 45212
Phone (513) 246-7796

7759 University Dr
Ste D
West Chester, OH 45069
Phone (513) 463-4300

Interoperability endpoints

  • Direct secure messaging: jsullivan40011@direct.trihealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1053340372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE",
            "address_2": "STE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123359",
            "telephone_number": "513-793-2220",
            "fax_number": "513-793-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11135 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492308",
            "telephone_number": "513-793-2220",
            "fax_number": "513-793-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OH",
            "license": "35.060447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09714269030",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.