Leo P Sullivan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

165823-1 Issued in NY

Practice address

4401 Middle Settlement Road
Suite 208
New Hartford, NY 13413

Phone

(315) 797-3430

Fax

(315) 624-7383

NPI assigned

Oct 31, 2005

Last updated

Feb 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

General Surgery

Education

New York University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Merit-based Incentive Payment System (MIPS)

Final score

85.28 of 100Reported as group

Quality

75.06

Promoting interoperability

100

Improvement activities

40

Cost

69.26

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsullivan13793@mvhealthsystem.direct-ci.com

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.

• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment Care Compare group NPD
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD
• MVHS Inc

  dba Wynn Hospital

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  NPD (past)
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1649350380
  NPD (past)

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

• MVHS Inc

  dba Wynn Hospital

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1437140472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MIDDLE SETTLEMENT ROAD",
            "address_2": "SUITE 208",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "13413",
            "telephone_number": "315-797-3430",
            "fax_number": "315-624-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MIDDLE SETTLEMENT ROAD",
            "address_2": "SUITE 208",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "13413",
            "telephone_number": "315-797-3430",
            "fax_number": "315-624-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LEO",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "165823-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01134596",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doris Dee Stockton, RDH, BT
• Emaree Stone, OD
• Susan Stone, F.N.P.
• Susan E Striegler, DC
• Strong Physical Therapy PLLC
• Shannon Sullivan, PT
• Brian Sumberg
• Colleen Klein Sunderlin, OTR
• Suny Health Science Center at Syracuse (Upstate Outpatient Pharmacy)
• Suresh Rayancha MD PC

• Surgery Physician in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.