Sonny Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011968 Issued in MI

Practice address

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Phone

(800) 532-2411

NPI assigned

Aug 10, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, 349 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssullivan1093613@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment Care Compare group
• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • MC Bain, MI
  • NPI 1336539063
  Medicare reassignment
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Macomb Hospital Corporation

  • Physician Assistant
  • Clinton TWP, MI
  • NPI 1124421888
  NPD
• Munson Healthcare Cadillac

  • Psychiatry Physician
  • Traverse City, MI
  • NPI 1720955081
  NPD
• Munson Healthcare Cadillac

  • Urology Physician
  • Cadillac, MI
  • NPI 1932726577
  NPD

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1215610779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 S MISSION RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488585531",
            "telephone_number": "989-854-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "800-532-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012331",
            "country_code": "US",
            "telephone_number": "231-876-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1970 Ashland Dr",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "MI",
            "postal_code": "488581203",
            "country_code": "US",
            "telephone_number": "989-854-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SONNY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601011968",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Stork, PA-C
• Julie Marie Straetmans
• Victoria Ann Strika, BEHAVIOR TECHNICIAN
• Andrell Sturdivant
• Leslie Styer, MA, LLP, CAADC
• Surgical Specialty Group LLC
• Trisha Denay Swan, LLMSW
• Paul Sweda, MD
• Therese S Swinburnson
• Michael Joseph Syska Jr., MPT

• Physician Assistant in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.