NPIMap

Individual provider Active NPI

Donald Nicholas Sullivan, M.D.

  • Orthopaedic Surgery Physician
  • Mt Zion, IL
National Provider Identifier
1154511517
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
125-052745 Issued in IL
Practice address
104 Ashland
Mt Zion, IL 62549
Phone
(217) 864-2665
Fax
(217) 864-8042
NPI assigned
Jul 31, 2007
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125-052745 IL Primary

Addresses

Primary practice location

104 Ashland
Mt Zion, IL 62549

Mailing address

104 Ashland
Mt Zion, IL 62549
Phone (217) 864-2665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130719000134 IL Practitioner - Orthopedic SurgeryPractitioner - Plastic and Reconstructive Surgery 4486894508 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Plastic and Reconstructive Surgery
Education
Southern College of Medicine and Surgery, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirby Medical CenterGroup PAC ID 6901791144, shared by 8 NPIs, 80 clinicians
Decatur Orthopedic Center LLCGroup PAC ID 4981844289, 9 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.5 of 100Reported as group
Quality
85.2
Improvement activities
40
Cost
68.05

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement50
Knee replacement99
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-052745ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Orthopedic Center, LLC Orthopaedic Surgery CurrentSince Aug 1, 2013 Accepting new patients
Pana Community Hospital Association CurrentSince Dec 17, 2020 Accepting new patients
Pana Community Hospital Association CurrentSince Dec 17, 2020 Accepting new patients
Kirby Medical Center CurrentSince Jan 3, 2026 Accepting new patients
Pana Community Hospital Association CurrentSince Dec 1, 2025 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

  • Direct secure messaging: donaldsullivan@docenter.allscriptsdirect.net

Organizations & group practices 9

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 12

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1154511517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ASHLAND",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "62549",
            "telephone_number": "217-864-2665",
            "fax_number": "217-864-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ASHLAND",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "62549",
            "telephone_number": "217-864-2665",
            "fax_number": "217-864-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DONALD",
        "middle_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-052745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Zion, IL

Sources for this page

Verify at the official NPI Registry.