William Sullivan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD 22176 Issued in AZ

Practice address

5100 E Highway 90
Suite B
Sierra Vista, AZ 85635-2443

Phone

(520) 417-9729

Fax

(520) 417-9733

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, ID, TX3 enrollments

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 3

Specialty

Psychiatry

Education

Texas Tech University Health Science Center School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Carlos Apache Healthcare CorporationGroup PAC ID 0648580597, 147 clinicians

St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

Merit-based Incentive Payment System (MIPS)

Final score

85.09 of 100Reported as group

Quality

77.1

Promoting interoperability

100

Improvement activities

40

Cost

73.19

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment Care Compare group NPD
• Sullivan MD PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sierra Vista, AZ
  • NPI 1851531933

  Psychiatry

  Medicare reassignment NPD Authorized official
• St Luke'S Clinic LLC

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment Care Compare group NPD
• San Carlos Apache Healthcare Corporation

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• San Pedro Health

  • Community/Behavioral Health Agency
  • Sierra Vista, AZ
  • NPI 1841636776
  NPD (past)
• San Pedro Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sierra Vista, AZ
  • NPI 1245501188
  NPD (past)
• St Lukes Magic Valley Regional Medical Center LTD

  • Psychiatric Hospital Unit
  • Twin Falls, ID
  • NPI 1164469870
  NPD (past)

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075
  Care Compare affiliation
• San Carlos Apache Healthcare Corporation

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1154483477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 E HIGHWAY 90",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352443",
            "telephone_number": "520-417-9729",
            "fax_number": "520-417-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 E HIGHWAY 90",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352443",
            "telephone_number": "520-417-9729",
            "fax_number": "520-417-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "MD 22176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "192774",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela S Strebe, SLPA
• G. Delaney Sturgeon, MD
• Ericka Jean Sullins
• Sullivan MD PLLC
• Tamika Michelle Sullivan, LCSW
• Suncloud Chiropractic, PLLC
• Sunrise Behavior Solutions PLLC
• Saumya Surti Mahammad, DO
• Laurence M Susini, MD
• Kelsey Tatum Sutherland, DPT

• Psychiatry Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.