Roger Patrick Sullivan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LL33609 Issued in SC

Practice address

9228 Medical Plaza Dr
Dept Family Medicine
Charleston, SC 29406-9125

Phone

(843) 876-7080

NPI assigned

Jun 7, 2011

Sex

Male

Sole proprietor

Yes

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 SC

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

Specialty

Dermatology

Education

Medical University of South Carolina College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Dermatology PCGroup PAC ID 6709164056, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roper Hospital Hospital, Charleston, SC, CCN 420087
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Charleston Dermatology, PC

  • Dermatology Physician
  • North Charleston, SC
  • NPI 1609320217
  Medicare reassignment Care Compare group NPD
• Trident Dermatology, PA

  • Dermatology Physician
  • Charleston, SC
  • NPI 1366404659
  Medicare reassignment NPD

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

• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1346534484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "address_2": "DEPT FAMILY MEDICINE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-876-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "address_2": "DEPT FAMILY MEDICINE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-876-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ROGER",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL33609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Sullivan, LPC, LMFT
• Henson Sullivan, CAA
• Lauren Joyce Sullivan, M.D.
• Rebecca Sullivan, COTA/L
• Robert Sullivan, M.D.
• Sheila Diane Sullivan, RN
• Victoria Anne Sullivan, MD
• Summer Sol Counseling
• Andrea P Summer, MD
• Elmina Lanier Summerall, MD

• Family Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.