Lisa Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14637 Issued in MN

Practice address

3580 Arcade St
Vadnais Heights, MN 55127-7135

Phone

(651) 968-5201

Fax

(651) 968-5903

NPI assigned

Sep 5, 2023

Last updated

Nov 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group NPD
• Summit Orthopedics LTD

  • Orthopaedic Surgery Physician
  • Eden Prairie, MN
  • NPI 1417639626
  NPD
• Ilbnc, P.a.

  dba Institute for Low Back & Neck Care

  • Orthopaedic Surgery of the Spine Physician
  • Bloomington, MN
  • NPI 1023001815
  NPD (past)
• Summit Orthopedics, LTD.

  dba Minnesota Occupational Health

  • Occupational Medicine Clinic/Center
  • Saint Paul, MN
  • NPI 1275684128
  NPD (past)

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

• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1225199128
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Ridges Hospital

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Southdale Hospital

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1184400335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Stolt, LPCC, LADC
• Caroline Susan Stommes, PT
• Shannon Nicole Stuart
• Edward T Su, MD
• Suite Living Senior Care of Vadnais Heights (Suite Living of Vadnais Heights)
• Summit Orthopedics, LTD
• Summit Orthopedics, LTD (Summit Recovery Suites)
• Sunrise Healthcare Services LLC
• Deborah Ann Tatge, MS, CCC-SLP
• Makayla Sherrell Taylor

• Physician Assistant in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.