Donald Nicholas Sullivan, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · Mt Zion, IL
NPI 1154511517 · NPPES record last updated Jul 13, 2022
Key facts
- NPI
- 1154511517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 125-052745 (IL)
- Practice address
- 104 Ashland
Mt Zion, IL 62549 - Phone
- (217) 864-2665
- Fax
- (217) 864-8042
- NPI assigned
- Jul 31, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Southern College of Medicine and Surgery, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kirby Medical Center
Pana Community Hospital Association
Decatur Orthopedic Center LLC
Practice addresses (Care Compare)
1000 Medical Ctr Dr
Monticello, IL 61856-2116
Phone (217) 762-1540
101 E 9TH St
Pana, IL 62557-1716
Phone (217) 562-6246
104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone (217) 864-2665
Hospital & facility affiliations
- Memorial Home Services
- HSHS Home Care Illinois
- Enhabit Home Health
- Sarah Bush Lincoln Home Care
- Carle Home Care
- Decatur Memorial Hospital
- St Marys Hospital
- Kirby Medical Center
- Sarah Bush Lincoln Health Center
- St Anthonys Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 72.1
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.5 of 100
- Quality
- 85.2
- Improvement activities
- 40
- Cost
- 68.05
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 72.1
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 50 |
| Knee replacement | 99 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130719000134 | IL | Practitioner - Orthopedic Surgery |
4486894508 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-052745 | IL | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Decatur Orthopedic Center, LLC | Orthopaedic Surgery | Current |
Accepting new patients |
| Kirby Medical Center | Current |
Accepting new patients | |
| Pana Community Hospital Association | Current |
Accepting new patients | |
| Pana Community Hospital Association | Current |
Accepting new patients | |
| Pana Community Hospital Association | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Kirby Medical Center | Past | Accepting new patients |
Locations
1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540
104 E Ashland Ave
Mt Zion, IL 62549
Phone (217) 864-2665
101 E 9th St
Pana, IL 62557
Phone (217) 562-2131
Interoperability endpoints
- donaldsullivan@docenter.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 125-052745 | IL | Yes |
Addresses
Primary practice location
104 Ashland
Mt Zion, IL 62549
Mailing address
104 Ashland
Mt Zion, IL 62549
Phone (217) 864-2665
Other providers in Mt Zion, IL
- Stepping Stones to Independence Inc
- Charles Howard Stone
- Howard Arch Stone
- Jenna Nicole Stowers
- Sullivan & Sams Medical, LLC
- Temmen Advanced Eye Care LLC
- Kelsey Marie Thacker
- Ryan Scott Thoele
- Three Olive Branches Counseling LLC
- Amanda Torrance
All providers in Mt Zion, IL · Orthopaedic Surgery Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.