Kathryn Therese Sullivan Dillie, MD, PHD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

53697-20 Issued in WI

Practice address

620 W Brown St
Waupun, WI 53963-1702

Phone

(920) 324-5581

NPI assigned

Aug 3, 2008

Sex

Female

Sole proprietor

No

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 WI

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

Emergency Medicine

Education

University of Wisconsin School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
• Ripon Medical Center Hospital, Ripon, WI, CCN 521321

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksullivandillie510635@direct-ehr-ssmhc.com

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.

• Agnesian Healthcare, Inc

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Medicare reassignment Care Compare group NPD
• Agnesian Healthcare Inc

  • Community/Retail Pharmacy
  • Waupun, WI
  • NPI 1366417917
  NPD
• Agnesian Healthcare Inc

  • Family Medicine Physician
  • Fond Du Lac, WI
  • NPI 1730162991
  NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  NPD

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

• Ripon Medical Center Inc

  • Critical Access Hospital
  • Ripon, WI
  • NPI 1053362624
  Care Compare affiliation
• Waupun Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Waupun, WI
  • NPI 1528046737
  Care Compare affiliation
• Waupun Memorial Hospital

  • Critical Access Hospital
  • Waupun, WI
  • NPI 1548248644
  Care Compare affiliation

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

{
    "created_epoch": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1548426141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-5581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-7299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN DILLIE",
        "first_name": "KATHRYN",
        "middle_name": "THERESE",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-03",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53697-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnae Shaw, RN BSN NCSN
• Stephen Slattery
• Andrea Marie Smits, APNP
• St. Marys Dean Ventures Inc.
• Olly Christian Stewart, PT, DPT
• Jessica Y Sullivan, NP
• Paul Henry Sumnicht, M.D.
• Tammy Narance LPC SC
• Samantha L Thiede, APNP
• Donna L Thomas, OTR, CKTP

• Emergency Medicine Physician in Waupun, WI
• Providers in Waupun, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.