Individual provider Active NPI

Charise N Sullivan, PA-C

  • Physician Assistant
  • Webster, TX
National Provider Identifier
1386825909
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08489 Issued in TX
Practice address
500 E Medical Center Blvd
Webster, TX 77598
Phone
(281) 332-2511
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10356 MN
Physician Assistant 363A00000X PA08489 TX Primary

Addresses

Primary practice location

500 E Medical Center Blvd
Webster, TX 77598

Mailing address

8325 Broadway St
Ste 202 283
Pearland, TX 77581
Phone (832) 870-3730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20131018000338 TX Practitioner - Physician Assistant 7113008079 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nluc PLLCGroup PAC ID 3072752302, 219 clinicians
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians
Next Level MV LLCGroup PAC ID 5991062085, 124 clinicians

Practice addresses (Care Compare)

101 Winding Way St
Suite a
Lake Jackson, TX 77566-5358
Phone (281) 783-8162

1246 N FM 3083 Rd W
Suite B
Conroe, TX 77304-5340
Phone (281) 783-8162

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

1500 S Main St
Fort Worth, TX 76104-4917

1500 S Main St FL
1 Urgent Care Center
Fort Worth, TX 76104-4917
Phone (817) 702-1451

16312 Southwest Fwy
Sugar Land, TX 77479-2371
Phone (281) 783-8162

2560 E League City Pkwy
League City, TX 77573-6459
Phone (281) 783-8162

4002 FM 762 Rd
Suite 100
Rosenberg, TX 77469-5558
Phone (281) 783-8162

4936 Beechnut St
Houston, TX 77096-1605
Phone (281) 783-8162

5211 FM 2920 Rd
Suite 101
Spring, TX 77388-3004
Phone (281) 783-8162

5749 San Felipe St
Houston, TX 77057-3101
Phone (281) 783-8162

8100 Hwy 6 N
Suite E
Houston, TX 77095-1923
Phone (281) 783-8162

8325 Broadway St
Suite 220
Pearland, TX 77581-5773
Phone (281) 783-8162

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10356MNMDPhysician Assistant
PA08489TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Next Level MV LLC Current Accepting new patients
Nluc PLLC CurrentSince May 25, 2021 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Minimally Invasive Brain and Spine, PLLC Past Accepting new patients

Locations

7710 Garth Rd
Ste A
Baytown, TX 77521

6342 Phelan Blvd
Beaumont, TX 77706
Phone (281) 783-7182

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

4435 Kingwood Dr
Kingwood, TX 77339
Phone (281) 360-7711

101 Winding Way St
Ste A
Lake Jackson, TX 77566

8325 Broadway St
Ste 220
Pearland, TX 77581
Phone (281) 873-8162

4002 FM 762 Rd
Ste 100
Rosenberg, TX 77469

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Organizations & group practices 7

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": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1386825909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 BROADWAY ST",
            "address_2": "STE 202 283",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "832-870-3730",
            "fax_number": "281-258-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-332-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHARISE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10356",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.