Ann Nicole Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9113026 Issued in FL

Practice address

1301 Palm Ave
Jacksonville, FL 32207-8432

Phone

(904) 202-7300

Fax

(904) 202-2754

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Ann Nicole Sullivan Professional name

Medicare fee-for-service enrollment

Enrolled in CO, FL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Family Practice Associates, LLCGroup PAC ID 8820003411, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Merit-based Incentive Payment System (MIPS)

Final score

85.84 of 100Reported as group

Quality

73.65

Promoting interoperability

100

Improvement activities

40

Cost

74.43

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asullivan53103@baptisthealthsystemjacksonville.direct-ci.com
• Direct secure messaging: ann.sullivan@hca5.eclinicaldirectplus.com

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

• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  Medicare reassignment Care Compare group
• Baptist MD Anderson Cancer Physicians Inc

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1538593124
  Medicare reassignment
• Colorado Voice Clinic, P.C.

  • Otolaryngology Physician
  • Denver, CO
  • NPI 1083836423
  Medicare reassignment
• Healthone Clinic Services-Surgical Specialties LLC

  • Surgery Physician
  • Denver, CO
  • NPI 1639376585
  NPD
• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637

  Medical

  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814

  Medical

  NPD (past)

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

• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1073609707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078432",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA3713",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9113026",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113026",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03286",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA3713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "SULLIVAN",
            "middle_name": "NICOLE",
            "credential": "P.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Iram Suhel
• Julian Stephen Suhrer, MD
• Marianny Nazareth Sulbaran Nava, MD, PH.D.
• Ilkhom Suleymanov
• Stephanie Sulkala
• Annamarie Sullivan, O.D.
• David Kevin Sullivan, D.M.D.
• Deyja Sullivan
• Gloria Cherish Hope Sullivan, CRNA
• Helen Sullivan, LDO

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.