Individual provider Active NPI

Kevin Michael Sullivan, MD

  • Surgical Oncology Physician
  • New Orleans, LA
National Provider Identifier
1306264890
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
340298 Issued in LA
Practice address
2021 Perdido St FL 8
New Orleans, LA 70112-1352
Phone
(504) 568-4750
Fax
(504) 568-2202
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 340298 LA Primary
Surgery Physician 208600000X A171748 CA
Surgery Physician 208600000X ML60475569 WA

Addresses

Primary practice location

2021 Perdido St FL 8
New Orleans, LA 70112-1352

Mailing address

2021 Perdido St FL 8
New Orleans, LA 70112-1352
Phone (504) 568-4750

Other practice location 1

1500 E. Duarte Rd
Malp 02.062
Duarte, CA 91010
Phone (414) 379-6223

Other practice location 2

1959 NE Pacific St
Box 356410
Seattle, WA 98195-0001
Phone (206) 543-3687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003669 LA Practitioner - Surgical Oncology 0446579270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 Canal St
New Orleans, LA 70112-3018
Phone (504) 702-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
81.06
Promoting interoperability
100
Improvement activities
40
Cost
71.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171748CAMDSurgery Physician
340298LAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Apr 1, 2024 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Apr 1, 2024 Accepting new patients

Locations

478 S Johnson St
New Orleans, LA 70112
Phone (504) 412-1366

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

2021 Perdido St
Fl 8
New Orleans, LA 70112
Phone (504) 568-4750

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1306264890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 PERDIDO ST FL 8",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121352",
            "telephone_number": "504-568-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 PERDIDO ST FL 8",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121352",
            "telephone_number": "504-568-4750",
            "fax_number": "504-568-2202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E. Duarte Rd",
            "address_2": "MALP 02.062",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "91010",
            "country_code": "US",
            "telephone_number": "414-379-6223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1959 NE Pacific St",
            "address_2": "Box 356410",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-3687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "LA",
            "license": "340298",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A171748",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML60475569",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.